Provider Demographics
NPI:1659099950
Name:MARKS, KELSEY ANNE
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:ANNE
Last Name:MARKS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:KELSEY
Other - Middle Name:ANNE
Other - Last Name:FROHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:81 WARREN ST APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5980
Mailing Address - Country:US
Mailing Address - Phone:646-420-3541
Mailing Address - Fax:
Practice Address - Street 1:81 WARREN ST APT 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5980
Practice Address - Country:US
Practice Address - Phone:646-420-3541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001459221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist