Provider Demographics
NPI:1629802061
Name:VIEROW, KELSEY MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:MARIE
Last Name:VIEROW
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 1:29 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14546-1315
Mailing Address - Country:US
Mailing Address - Phone:315-925-3890
Mailing Address - Fax:
Practice Address - Street 1:1057 E HENRIETTA RD STE 500
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2655
Practice Address - Country:US
Practice Address - Phone:315-258-3811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029360225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist