Provider Demographics
NPI:1740772623
Name:MAAG, CHELSEA (AUD)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:
Last Name:MAAG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6707 THORNWOOD ST UNIT 8
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-4148
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6700 WASHINGTON AVE S
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3405
Practice Address - Country:US
Practice Address - Phone:952-222-3843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1060-A231H00000X
231H00000X
MO2021043546231H00000X
TX81416231H00000X
AZAUD13407231H00000X
WALD61208776231H00000X
AK183140231H00000X
CAAU3312231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist