MEDICARE: KELSI JOSEPHINE COX OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XM0800X	Mental Health Occupational Therapist	107966	MN

General Provider Information

NPI Number	:	1275475097
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSI JOSEPHINE COX OTR/L

Provider Business Mailing Address
First Line	:	1394 JACKSON ST
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55117-4629
Country	:	US
Telephone Number	:	318-572-9934
Fax Number	:

Provider Business Practice Location Address
First Line	:	1394 JACKSON ST
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55117-4629
Country	:	US
Telephone Number	:	318-572-9934
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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