Provider Demographics
NPI:1487202438
Name:DERKACZ, CHELSEA MILES (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:MILES
Last Name:DERKACZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:LEE
Other - Last Name:MILES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3109 WILMONT DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-3415
Mailing Address - Country:US
Mailing Address - Phone:610-299-0928
Mailing Address - Fax:
Practice Address - Street 1:12 LANDERS LN
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-2023
Practice Address - Country:US
Practice Address - Phone:302-429-4085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist