Provider Demographics
NPI:1104700061
Name:MANKINS, KEELY (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:KEELY
Middle Name:
Last Name:MANKINS
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 1:2940 DISNEY ST UNIT 319
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45209-5021
Mailing Address - Country:US
Mailing Address - Phone:614-204-7716
Mailing Address - Fax:
Practice Address - Street 1:527 WATSON RD
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018-1556
Practice Address - Country:US
Practice Address - Phone:859-727-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH013366225X00000X
KY301396225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist