Provider Demographics
NPI:1760162127
Name:ADKINS, CHELSEA (SLP)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:ADKINS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:MCENTYRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1606 CLAYTON RD
Mailing Address - Street 2:
Mailing Address - City:CHIPLEY
Mailing Address - State:FL
Mailing Address - Zip Code:32428-5702
Mailing Address - Country:US
Mailing Address - Phone:850-658-2101
Mailing Address - Fax:
Practice Address - Street 1:2102B MUD HILL RD
Practice Address - Street 2:
Practice Address - City:CHIPLEY
Practice Address - State:FL
Practice Address - Zip Code:32428-3874
Practice Address - Country:US
Practice Address - Phone:850-658-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA21513235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist