Provider Demographics
NPI:1144577610
Name:OWENS, CHELSI CHRISTINE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHELSI
Middle Name:CHRISTINE
Last Name:OWENS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 E 5TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-6471
Mailing Address - Country:US
Mailing Address - Phone:618-463-5171
Mailing Address - Fax:618-463-5175
Practice Address - Street 1:815 E 5TH ST STE 101
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-6471
Practice Address - Country:US
Practice Address - Phone:618-463-5171
Practice Address - Fax:618-463-5175
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.011122235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist