Provider Demographics
NPI:1720380546
Name:DUGAN, CHELSEA DAVIS (MS, CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:CHELSEA
Middle Name:DAVIS
Last Name:DUGAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MANHATTAN AVE
Mailing Address - Street 2:APT. 1618
Mailing Address - City:UNION CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07087-5240
Mailing Address - Country:US
Mailing Address - Phone:908-902-3097
Mailing Address - Fax:
Practice Address - Street 1:100 MANHATTAN AVE
Practice Address - Street 2:APT 1618
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-5240
Practice Address - Country:US
Practice Address - Phone:908-902-3097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YF00626900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist