Individual
KELSIE CHASTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1701 SHARP RD, WATERFORD, WI 53185-5214
(262) 534-7297
Mailing address
1701 SHARP RD, WATERFORD, WI 53185-5214
(262) 534-7297
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6522-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61304
EMPLOYEE
—
Enumeration date
03/26/2021
Last updated
03/26/2021
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