Provider Demographics
NPI:1174641401
Name:KAUK-COFIELD, KELSY G (COTA)
Entity Type:Individual
Prefix:MRS
First Name:KELSY
Middle Name:G
Last Name:KAUK-COFIELD
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 LYNCHBURG AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKNEAL
Mailing Address - State:VA
Mailing Address - Zip Code:24528-2808
Mailing Address - Country:US
Mailing Address - Phone:434-941-7507
Mailing Address - Fax:
Practice Address - Street 1:712 LYNCHBURG AVE
Practice Address - Street 2:
Practice Address - City:BROOKNEAL
Practice Address - State:VA
Practice Address - Zip Code:24528-2808
Practice Address - Country:US
Practice Address - Phone:434-941-7507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant