Provider Demographics
NPI:1770257487
Name:LESHEN, KELSIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:KELSIE
Middle Name:
Last Name:LESHEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10356 NE 76TH AVE
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50169-9561
Mailing Address - Country:US
Mailing Address - Phone:515-205-1813
Mailing Address - Fax:
Practice Address - Street 1:7755 OFFICE PLAZA DR. S
Practice Address - Street 2:SUITE 105
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266
Practice Address - Country:US
Practice Address - Phone:515-505-7283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA109422225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist