Provider Demographics
NPI:1164591228
Name:FREAS BOYLE, CHELSEA SHYE (OT)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:SHYE
Last Name:FREAS BOYLE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:CHELSEA
Other - Middle Name:SHYE
Other - Last Name:FREAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:611 NATIONAL HWY
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-7225
Mailing Address - Country:US
Mailing Address - Phone:301-729-9722
Mailing Address - Fax:
Practice Address - Street 1:157 BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2319
Practice Address - Country:US
Practice Address - Phone:301-722-3215
Practice Address - Fax:301-722-1450
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04437225X00000X
PAOC008637225X00000X
VA0119004128225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist