Provider Demographics
NPI:1043868706
Name:PLAISTED, CHELYNNE
Entity Type:Individual
Prefix:
First Name:CHELYNNE
Middle Name:
Last Name:PLAISTED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GLADESWORTH DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-2310
Mailing Address - Country:US
Mailing Address - Phone:931-434-0437
Mailing Address - Fax:
Practice Address - Street 1:214 E CURTIS ST
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-2622
Practice Address - Country:US
Practice Address - Phone:864-841-8341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNO OTHER PROVIDER IDENTIFIERS