MEDICARE: CHELSEY UCKOTTER

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	:	1861969800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSEY UCKOTTER

Provider Business Mailing Address
First Line	:	9130 LEWIS AVE
Second Line	:
City	:	BLUE ASH
State	:	OH
Zip	:	45242-7440
Country	:	US
Telephone Number	:	513-515-9050
Fax Number	:

Provider Business Practice Location Address
First Line	:	831 DORGENE LN
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45244-5009
Country	:	US
Telephone Number	:	513-200-4579
Fax Number	:

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

Provider Enumeration Date	:	10/29/2018
Last Update Date	:	10/13/2023

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Directions to “ CHELSEY UCKOTTER ” Practice Location

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