Provider Demographics
NPI:1336753193
Name:DOERRER, KELSI AIMEE (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:KELSI
Middle Name:AIMEE
Last Name:DOERRER
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3323 CROOKED TREE DR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-7968
Mailing Address - Country:US
Mailing Address - Phone:513-508-3815
Mailing Address - Fax:
Practice Address - Street 1:1960 MADISON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45206-1884
Practice Address - Country:US
Practice Address - Phone:513-751-5880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT011099225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist