Individual
KELSEY CASTEUBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5700 BOYNTON PL, RICHMOND, VA 23225-2506
(804) 837-0951
Mailing address
5700 BOYNTON PL, RICHMOND, VA 23225-2506
(804) 837-0951
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131002110
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0131002110
LICENSE
VA
Enumeration date
08/25/2022
Last updated
01/17/2024
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