Provider Demographics
NPI:1669947321
Name:MURDOCK, KELSEY MARIE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:MARIE
Last Name:MURDOCK
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 1:64 OAK TREE CIR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-2112
Mailing Address - Country:US
Mailing Address - Phone:479-670-3037
Mailing Address - Fax:
Practice Address - Street 1:304 SORENSON ST
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72118-3473
Practice Address - Country:US
Practice Address - Phone:501-246-5191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR3221225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist