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General NPI Number Information
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NPI Number | 1780025403
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Entity Type | Individual
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Provider Name | CHELSEA NINE
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Gender | Female
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Dates
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Enumeration Date | 07/10/2013
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Last Update Date | 08/08/2022
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Provider Practice Location Address
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Address Line | 6101 N STATE LINE AVE
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City | TEXARKANA
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State | TX
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Zip | 75503-5309
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Country | US
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Telephone | 903-791-2270
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Fax |
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Provider Business Mailing Address
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Address Line | 1362 B K PICKERING DR
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City | TEXARKANA
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State | TX
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Zip | 75501-0906
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Country | US
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Telephone | 903-733-5275
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 119526
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License Number State | TX
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