Healthcare Provider Details

I. General information

NPI: 1447942867
Provider Name (Legal Business Name): CHELSEY YARBROUGH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEY HODGE

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5734 W GLENDALE AVE
GLENDALE AZ
85301-2546
US

IV. Provider business mailing address

27777 INKSTER RD
FARMINGTON HILLS MI
48334-5310
US

V. Phone/Fax

Practice location:
  • Phone: 602-880-3417
  • Fax:
Mailing address:
  • Phone: 248-299-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: