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General NPI Number Information
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NPI Number | 1356764138
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Entity Type | Individual
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Provider Name | KELSEY LAUREN W. SINCLAIR MOT, OTR
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Gender | Female
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Dates
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Enumeration Date | 01/29/2014
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Last Update Date | 04/29/2015
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Provider Practice Location Address
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Address Line | 13720 MIDWAY RD SUITE 107
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City | DALLAS
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State | TX
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Zip | 75244-4313
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Country | US
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Telephone | 214-646-1449
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Fax | 214-516-7979
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Provider Business Mailing Address
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Address Line | 13720 MIDWAY RD SUITE 107
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City | DALLAS
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State | TX
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Zip | 75244-4313
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Country | US
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Telephone | 214-646-1449
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Fax | 214-516-7979
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 305226
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 115905
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License Number State | TX
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