Provider Demographics
NPI:1215205927
Name:ROBERTS, CHELSEA A (SP)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:A
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1743
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-8158
Mailing Address - Country:US
Mailing Address - Phone:916-899-0822
Mailing Address - Fax:
Practice Address - Street 1:3896 FM 546
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:TX
Practice Address - Zip Code:75407-4101
Practice Address - Country:US
Practice Address - Phone:214-994-7920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP18751235Z00000X
TX108692235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist