Healthcare Provider Details

I. General information

NPI: 1609549351
Provider Name (Legal Business Name): KELSEY LEIGH KNERR OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY LEIGH HENDRICKSON OTR/L

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 W WOODMEN RD
COLORADO SPRINGS CO
80919-2726
US

IV. Provider business mailing address

1130 W WOODMEN RD
COLORADO SPRINGS CO
80919-2726
US

V. Phone/Fax

Practice location:
  • Phone: 719-574-5562
  • Fax:
Mailing address:
  • Phone: 719-574-5562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0006966
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: