Healthcare Provider Details

I. General information

NPI: 1699168278
Provider Name (Legal Business Name): KELSEY LAUREN FORBRINGER MSOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2015
Last Update Date: 04/06/2021
Certification Date: 04/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7770 E ILIFF AVE STE C
DENVER CO
80231-5326
US

IV. Provider business mailing address

9328 LITZSINGER RD
SAINT LOUIS MO
63144-2128
US

V. Phone/Fax

Practice location:
  • Phone: 303-333-8360
  • Fax:
Mailing address:
  • Phone: 815-861-6458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT.0005039
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: