Healthcare Provider Details

I. General information

NPI: 1437469863
Provider Name (Legal Business Name): KATHY S NELSON OTR/L, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHY S OROZCO OTR/L, CHT

II. Dates (important events)

Enumeration Date: 10/19/2010
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4004 PEACH CT STE H
COLUMBIA MO
65203-3800
US

IV. Provider business mailing address

1739 ELM CT STE 205206
JEFFERSON CITY MO
65101-4303
US

V. Phone/Fax

Practice location:
  • Phone: 573-256-8100
  • Fax: 573-256-8104
Mailing address:
  • Phone: 630-575-1980
  • Fax: 630-928-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number004272
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: