Provider Demographics
NPI:1417382110
Name:HALL, CHELSEY (MSOT)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6804 BERKELEY ESTATES LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2966
Mailing Address - Country:US
Mailing Address - Phone:540-529-0614
Mailing Address - Fax:
Practice Address - Street 1:1610 FOREST AVE STE 210
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5009
Practice Address - Country:US
Practice Address - Phone:804-282-4596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119005946225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist