Provider Demographics
NPI:1740593789
Name:TAGGART, CHELSEA LEIGH (PTA)
Entity Type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:LEIGH
Last Name:TAGGART
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 POPLAR GROVE PL
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-2768
Mailing Address - Country:US
Mailing Address - Phone:443-752-1617
Mailing Address - Fax:410-727-2186
Practice Address - Street 1:22 NEWPORT DR
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:MD
Practice Address - Zip Code:21050-1642
Practice Address - Country:US
Practice Address - Phone:443-752-1617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD151918225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant