Provider Demographics
NPI:1407316417
Name:REINHARD, KELSI (COTA/L)
Entity Type:Individual
Prefix:
First Name:KELSI
Middle Name:
Last Name:REINHARD
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 232
Mailing Address - Street 2:
Mailing Address - City:NEW RIEGEL
Mailing Address - State:OH
Mailing Address - Zip Code:44853-0232
Mailing Address - Country:US
Mailing Address - Phone:419-618-5549
Mailing Address - Fax:
Practice Address - Street 1:12 1/2 S. PERRY ST.
Practice Address - Street 2:
Practice Address - City:NEW RIEGEL
Practice Address - State:OH
Practice Address - Zip Code:44853-4485
Practice Address - Country:US
Practice Address - Phone:419-618-5549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA.05539224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant