Provider Demographics
NPI:1578992236
Name:MITCHELL, CHELSEA (MSED/CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:MSED/CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2124 NE 123RD ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2881
Mailing Address - Country:US
Mailing Address - Phone:305-895-0444
Mailing Address - Fax:305-895-0490
Practice Address - Street 1:2124 NE 123RD ST
Practice Address - Street 2:SUITE 210
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2881
Practice Address - Country:US
Practice Address - Phone:305-895-0444
Practice Address - Fax:305-895-0490
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA13696235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist