Provider Demographics
NPI:1033659453
Name:WADDELOW, CHELSEA (MMT, MT-BC)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:WADDELOW
Suffix:
Gender:F
Credentials:MMT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4345 HALLIWELL DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-6404
Mailing Address - Country:US
Mailing Address - Phone:919-357-5942
Mailing Address - Fax:
Practice Address - Street 1:4345 HALLIWELL DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-6404
Practice Address - Country:US
Practice Address - Phone:919-357-5942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-04
Last Update Date:2017-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist