MEDICARE: CHELSEA WHITTAKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1417658758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEA WHITTAKER

Provider Business Mailing Address
First Line	:	9200 NW 39TH AVE STE 130-1020
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-7331
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9200 NW 39TH AVENUE
Second Line	:	SUITE 130-1020
City	:	GAINESVILLE
State	:	FL
Zip	:	32606-7331
Country	:	US
Telephone Number	:	413-813-4605
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2023
Last Update Date	:	04/06/2026

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Directions to “ CHELSEA WHITTAKER ” Practice Location

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