Provider Demographics
NPI:1356764138
Name:SINCLAIR, KELSEY LAUREN W (MOT, OTR)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:LAUREN W
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13720 MIDWAY RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-4313
Mailing Address - Country:US
Mailing Address - Phone:214-646-1449
Mailing Address - Fax:214-516-7979
Practice Address - Street 1:13720 MIDWAY RD
Practice Address - Street 2:SUITE 107
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-4313
Practice Address - Country:US
Practice Address - Phone:214-646-1449
Practice Address - Fax:214-516-7979
Is Sole Proprietor?:No
Enumeration Date:2014-01-29
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX305226225XP0200X
TX115905225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics