Provider Demographics
NPI:1649020041
Name:HOELSCHER, KASEY DAWN (OTR/L)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:DAWN
Last Name:HOELSCHER
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 1:801 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:MO
Mailing Address - Zip Code:63552-2064
Mailing Address - Country:US
Mailing Address - Phone:660-346-1286
Mailing Address - Fax:
Practice Address - Street 1:2 HARBOR BEND CT STE 102
Practice Address - Street 2:
Practice Address - City:LAKE ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-1480
Practice Address - Country:US
Practice Address - Phone:022-696-7490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024007509225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist