Provider Demographics
NPI:1205418522
Name:MAKOWSKI, CHELSEA M
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:M
Last Name:MAKOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:M
Other - Last Name:FARES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:824 BOWTOWN RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-9661
Mailing Address - Country:US
Mailing Address - Phone:740-695-7795
Mailing Address - Fax:740-362-4411
Practice Address - Street 1:824 BOWTOWN RD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-9661
Practice Address - Country:US
Practice Address - Phone:740-695-7795
Practice Address - Fax:740-362-4411
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist