Provider Demographics
NPI:1629691720
Name:CASHEM, CHELSEY JOI
Entity Type:Individual
Prefix:MRS
First Name:CHELSEY
Middle Name:JOI
Last Name:CASHEM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1554 THISTLEDOWN DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-2068
Mailing Address - Country:US
Mailing Address - Phone:270-304-5960
Mailing Address - Fax:
Practice Address - Street 1:498 PALM SPRINGS DR STE 345
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-7806
Practice Address - Country:US
Practice Address - Phone:407-494-0644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT20575225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT20575OtherOT LICENSURE