Healthcare Provider Details

I. General information

NPI: 1114442803
Provider Name (Legal Business Name): KELSIE LEE COLOMBINI O'DONNELL OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4741 CAUGHLIN PKWY STE 2
RENO NV
89519-0983
US

IV. Provider business mailing address

4741 CAUGHLIN PKWY STE 2
RENO NV
89519-0983
US

V. Phone/Fax

Practice location:
  • Phone: 775-376-1934
  • Fax: 775-451-3769
Mailing address:
  • Phone: 775-376-1934
  • Fax: 775-451-3769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number17-0903
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: