Healthcare Provider Details

I. General information

NPI: 1780401745
Provider Name (Legal Business Name): CHELSEA MICHELLE-LYN ACCARDO OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 09/23/2024
Certification Date: 09/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 E FLAMINGO RD STE 314
LAS VEGAS NV
89119-5193
US

IV. Provider business mailing address

2110 E FLAMINGO RD STE 314
LAS VEGAS NV
89119-5193
US

V. Phone/Fax

Practice location:
  • Phone: 702-947-5200
  • Fax: 702-947-5204
Mailing address:
  • Phone: 702-947-5200
  • Fax: 702-947-5204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-3557
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: