Healthcare Provider Details
I. General information
NPI: 1235801291
Provider Name (Legal Business Name): CHELSEA DONAHUE AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/29/2021
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 RIDGELY AVE STE 110
ANNAPOLIS MD
21401-1082
US
IV. Provider business mailing address
650 RITCHIE HWY STE 104
SEVERNA PARK MD
21146-3910
US
V. Phone/Fax
- Phone: 410-647-7795
- Fax: 410-315-8823
- Phone: 410-647-7795
- Fax: 410-315-8823
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | 01571 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: