Provider Demographics
NPI:1285237784
Name:CARUTHERS, KELSEY KAMINSKY (MS, OTR/L, BCPR)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:KAMINSKY
Last Name:CARUTHERS
Suffix:
Gender:F
Credentials:MS, OTR/L, BCPR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10322 MUIR BEND DR
Mailing Address - Street 2:
Mailing Address - City:ROSHARON
Mailing Address - State:TX
Mailing Address - Zip Code:77583-2994
Mailing Address - Country:US
Mailing Address - Phone:248-974-7921
Mailing Address - Fax:
Practice Address - Street 1:6621 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2399
Practice Address - Country:US
Practice Address - Phone:832-824-1000
Practice Address - Fax:832-825-2301
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117454225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics