Provider Demographics
NPI:1174928675
Name:REYNOLDS, KELSEY CRAWFORD (OT)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:CRAWFORD
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:BIGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 306393
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6393
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-614-8811
Practice Address - Street 1:2004 HAYES ST STE 545
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2655
Practice Address - Country:US
Practice Address - Phone:615-614-8833
Practice Address - Fax:615-614-8811
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4983225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist