Provider Demographics
NPI:1952824336
Name:COHEN, KELLY C (OTR/L)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:C
Last Name:COHEN
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 1:1900 L ST NW STE 607
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5047
Mailing Address - Country:US
Mailing Address - Phone:202-528-7223
Mailing Address - Fax:202-293-2262
Practice Address - Street 1:2110 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-5719
Practice Address - Country:US
Practice Address - Phone:973-908-7467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-18
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT010001326225X00000X
VA0119009626225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty