Provider Demographics
NPI:1437469863
Name:NELSON, KATHY S (OTR/L, CHT)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:S
Last Name:NELSON
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:S
Other - Last Name:OROZCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L, CHT
Mailing Address - Street 1:1739 ELM CT
Mailing Address - Street 2:STE 205206
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65101-4303
Mailing Address - Country:US
Mailing Address - Phone:630-575-1980
Mailing Address - Fax:630-928-5080
Practice Address - Street 1:4004 PEACH CT STE H
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-3800
Practice Address - Country:US
Practice Address - Phone:573-256-8100
Practice Address - Fax:573-256-8104
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO004272225XH1200X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand