Provider Demographics
NPI:1558719120
Name:WHITMIRE, CHELSEA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:WHITMIRE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:RAE
Other - Last Name:DILLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:807B MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:NC
Mailing Address - Zip Code:28315-2205
Mailing Address - Country:US
Mailing Address - Phone:419-889-0435
Mailing Address - Fax:
Practice Address - Street 1:807B MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:NC
Practice Address - Zip Code:28315-2205
Practice Address - Country:US
Practice Address - Phone:419-889-0435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL60641307235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist