Provider Demographics
NPI:1114442803
Name:COLOMBINI, KELSIE LEE (OT)
Entity Type:Individual
Prefix:
First Name:KELSIE
Middle Name:LEE
Last Name:COLOMBINI
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4741 CAUGHLIN PKWY STE 2
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89519-0983
Mailing Address - Country:US
Mailing Address - Phone:775-376-1934
Mailing Address - Fax:775-451-3769
Practice Address - Street 1:4741 CAUGHLIN PKWY STE 2
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-0983
Practice Address - Country:US
Practice Address - Phone:775-376-1934
Practice Address - Fax:775-451-3769
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-03
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV17-0903225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty