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General NPI Number Information
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NPI Number | 1366137820
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Entity Type | Individual
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Provider Name | KELSI NICOLE SANDFORD OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/10/2023
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 17710 EXCELSIOR BLVD
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City | MINNETONKA
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State | MN
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Zip | 55345-4113
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Country | US
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Telephone | 952-209-1440
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Fax |
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Provider Business Mailing Address
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Address Line | 9417 NORTHWOOD PKWY
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City | NEW HOPE
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State | MN
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Zip | 55427-1626
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Country | US
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Telephone | 612-408-7918
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Fax |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 107098
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License Number State | MN
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