Provider Demographics
NPI:1235750969
Name:TRIMBLE, CHELSEA MARIE
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MARIE
Last Name:TRIMBLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14182 PACIFIC POINT PL APT 205
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-1895
Mailing Address - Country:US
Mailing Address - Phone:610-906-2502
Mailing Address - Fax:
Practice Address - Street 1:21345 POWERLINE RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2300
Practice Address - Country:US
Practice Address - Phone:610-906-2502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20779225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist