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General NPI Number Information
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NPI Number | 1629935994
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Entity Type | Individual
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Provider Name | KELSEY DULIN
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Gender | Female
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 4800 EAGLEVIEW DR # 514
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City | OSAGE BEACH
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State | MO
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Zip | 65065-2757
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Country | US
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Telephone | 573-476-4732
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 EAGLEVIEW DR # 514
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City | OSAGE BEACH
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State | MO
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Zip | 65065-2757
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Country | US
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Telephone |
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 2019005372
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License Number State | MO
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