Healthcare Provider Details

I. General information

NPI: 1801418678
Provider Name (Legal Business Name): CHELSEA KIRTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2020
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14403 BRAEMAR ST
WINTER GARDEN FL
34787-7311
US

IV. Provider business mailing address

14403 BRAEMAR ST
WINTER GARDEN FL
34787-7311
US

V. Phone/Fax

Practice location:
  • Phone: 580-470-5250
  • Fax:
Mailing address:
  • Phone: 580-470-5250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number12031850-4102
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number34853
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSAH-2024-0172
License Number StateNM
# 4
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA17400
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number5148
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: