Provider Demographics
NPI:1982236444
Name:SCHELLER, KELSEY (OTR/L)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:SCHELLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9837 N AUBURN CT
Mailing Address - Street 2:
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-6049
Mailing Address - Country:US
Mailing Address - Phone:920-207-1250
Mailing Address - Fax:
Practice Address - Street 1:10995 N MARKET ST
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-4952
Practice Address - Country:US
Practice Address - Phone:262-478-1578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5637-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist