Provider Demographics
NPI:1083028294
Name:KILGORE, CHELSEA (AUD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:KILGORE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1991 N WILLIAMSBURG DR STE A
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3500
Mailing Address - Country:US
Mailing Address - Phone:404-500-1026
Mailing Address - Fax:404-478-6476
Practice Address - Street 1:1991 N WILLIAMSBURG DR STE A
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3500
Practice Address - Country:US
Practice Address - Phone:404-500-1026
Practice Address - Fax:404-478-6476
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003972231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist