Provider Demographics
NPI:1518272954
Name:VAN CALLIGAN, CHELSAE MARIE
Entity Type:Individual
Prefix:
First Name:CHELSAE
Middle Name:MARIE
Last Name:VAN CALLIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHELSAE
Other - Middle Name:MARIE
Other - Last Name:KRONSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8320 CITY CENTRE DR
Mailing Address - Street 2:SUITE G.
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-3382
Mailing Address - Country:US
Mailing Address - Phone:651-738-9888
Mailing Address - Fax:651-738-9889
Practice Address - Street 1:8320 CITY CENTRE DR
Practice Address - Street 2:SUITE G.
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-3382
Practice Address - Country:US
Practice Address - Phone:651-738-9888
Practice Address - Fax:651-738-9889
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN103946225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist