Provider Demographics
NPI:1790308534
Name:MONTOYA, CHELSEA (MSCCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:MISS
Other - First Name:CHELSEA
Other - Middle Name:
Other - Last Name:GRIMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:204 KAMAKOI LOOP
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7122
Mailing Address - Country:US
Mailing Address - Phone:808-344-1778
Mailing Address - Fax:
Practice Address - Street 1:204 KAMAKOI LOOP
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7122
Practice Address - Country:US
Practice Address - Phone:808-344-1778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty