Provider Demographics
NPI:1922633635
Name:KELSO, GRACE ANNABEL (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:ANNABEL
Last Name:KELSO
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 PENNSYLVANIA AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3027
Mailing Address - Country:US
Mailing Address - Phone:202-544-5439
Mailing Address - Fax:
Practice Address - Street 1:2301 COLUMBIA PIKE APT 125
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4453
Practice Address - Country:US
Practice Address - Phone:571-527-0818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist