Provider Demographics
NPI:1285173419
Name:HARKINS, KELSEY E (LAT, ATC)
Entity type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:E
Last Name:HARKINS
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08007-1107
Mailing Address - Country:US
Mailing Address - Phone:609-247-4071
Mailing Address - Fax:
Practice Address - Street 1:5 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08007-1107
Practice Address - Country:US
Practice Address - Phone:609-247-4071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2020-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT75462255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer