Provider Demographics
NPI:1164319448
Name:MILLS, KELSEY NICOLE (OTR/L)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:NICOLE
Last Name:MILLS
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 1:256 QUIET OAK LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25702-2042
Mailing Address - Country:US
Mailing Address - Phone:304-634-7033
Mailing Address - Fax:
Practice Address - Street 1:256 QUIET OAK LN
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-2042
Practice Address - Country:US
Practice Address - Phone:304-634-7033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1971225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics