Healthcare Provider Details

I. General information

NPI: 1235489378
Provider Name (Legal Business Name): CHELISE E. STRICKLAND ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2012
Last Update Date: 09/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 CASHO MILL RD SUITE 6
NEWARK DE
19711-3500
US

IV. Provider business mailing address

1501 CASHO MILL RD SUITE 6
NEWARK DE
19711-3500
US

V. Phone/Fax

Practice location:
  • Phone: 302-453-1588
  • Fax:
Mailing address:
  • Phone: 302-453-1588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberJ3-0000399
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberA0000317
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRT005011
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: