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General NPI Number Information
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NPI Number | 1386011971
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Entity Type | Individual
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Provider Name | KELSEY KLATT OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/31/2015
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Last Update Date | 09/07/2018
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Provider Practice Location Address
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Address Line | 6960 S 110TH ST
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City | LA VISTA
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State | NE
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Zip | 68128
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Country | US
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Telephone | 402-597-4835
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Fax | 402-331-4265
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Provider Business Mailing Address
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Address Line | 6949 S 110TH ST
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City | LA VISTA
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State | NE
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Zip | 68128-5721
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Country | US
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Telephone | 402-597-4800
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Fax | 402-497-4808
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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 | 1924
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License Number State | NE
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