Provider Demographics
NPI:1215605662
Name:HANSEN, CHELSI (MS, CCC/SLP, ATP)
Entity Type:Individual
Prefix:
First Name:CHELSI
Middle Name:
Last Name:HANSEN
Suffix:
Gender:F
Credentials:MS, CCC/SLP, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13885 WOODWAY DR
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:TX
Mailing Address - Zip Code:76712-7621
Mailing Address - Country:US
Mailing Address - Phone:254-761-5625
Mailing Address - Fax:254-761-5778
Practice Address - Street 1:13885 WOODWAY DR
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-7621
Practice Address - Country:US
Practice Address - Phone:254-761-5625
Practice Address - Fax:254-761-5778
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103883235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist