Provider Demographics
NPI:1336863109
Name:KINCAID, CHELSEY NICHOLE (MSOT, OTR/L)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:NICHOLE
Last Name:KINCAID
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 DUSKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HARVEST
Mailing Address - State:AL
Mailing Address - Zip Code:35749-4911
Mailing Address - Country:US
Mailing Address - Phone:304-731-1493
Mailing Address - Fax:
Practice Address - Street 1:306 WYNN DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-1961
Practice Address - Country:US
Practice Address - Phone:256-882-2457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6481225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist