Provider Demographics
NPI:1003358789
Name:MOREHEAD, CHELSEA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:
Last Name:MOREHEAD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 N CORAL CANYON LOOP APT 417
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-6283
Mailing Address - Country:US
Mailing Address - Phone:501-454-6588
Mailing Address - Fax:
Practice Address - Street 1:474 N CORAL CANYON LOOP APT 417
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-6283
Practice Address - Country:US
Practice Address - Phone:501-454-6588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2998225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist