Healthcare Provider Details

I. General information

NPI: 1558097501
Provider Name (Legal Business Name): KELSEY MACASKILL OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY VALLEE OTD, OTR/L

II. Dates (important events)

Enumeration Date: 07/30/2022
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 BROADWAY
LORAIN OH
44052-5542
US

IV. Provider business mailing address

6405 STAFFORD DR
NORTH OLMSTED OH
44070-4858
US

V. Phone/Fax

Practice location:
  • Phone: 440-233-5412
  • Fax:
Mailing address:
  • Phone: 440-591-7495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT012058
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: