Provider Demographics
NPI:1750014510
Name:COBBS, KELSEY MCKENNA (OTR/L)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:MCKENNA
Last Name:COBBS
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 1:12458 MCKELVEY RD APT 2
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-2939
Mailing Address - Country:US
Mailing Address - Phone:812-746-5852
Mailing Address - Fax:
Practice Address - Street 1:111 N EMERSON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-3770
Practice Address - Country:US
Practice Address - Phone:303-744-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist