Provider Demographics
NPI:1760512271
Name:BLISKEY, CHELSA MARIA (SLP)
Entity Type:Individual
Prefix:
First Name:CHELSA
Middle Name:MARIA
Last Name:BLISKEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12708 RIATA VISTA CIR
Mailing Address - Street 2:SUITE#A126
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-7167
Mailing Address - Country:US
Mailing Address - Phone:512-637-2002
Mailing Address - Fax:
Practice Address - Street 1:9101 BURNET RD
Practice Address - Street 2:STE 103
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5254
Practice Address - Country:US
Practice Address - Phone:512-248-2422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102563235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist