Healthcare Provider Details

I. General information

NPI: 1659029320
Provider Name (Legal Business Name): KELSIE MARIE SNAPP OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2022
Last Update Date: 03/12/2022
Certification Date: 03/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 CHESTNUT STATION CT
LOUISVILLE KY
40299-6395
US

IV. Provider business mailing address

3219 S ROBINSON PL
WEST TERRE HAUTE IN
47885-8982
US

V. Phone/Fax

Practice location:
  • Phone: 800-335-1060
  • Fax:
Mailing address:
  • Phone: 812-229-2592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31007685A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: