Provider Demographics
NPI:1811231103
Name:BRANNAN, CHELSEA JULIANO (AUD)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:JULIANO
Last Name:BRANNAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:JULIANO
Other - Last Name:DIECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:1222 S PATTERSON BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-2642
Mailing Address - Country:US
Mailing Address - Phone:937-496-2620
Mailing Address - Fax:937-424-8518
Practice Address - Street 1:1222 S PATTERSON BLVD STE 400
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-2642
Practice Address - Country:US
Practice Address - Phone:937-496-2620
Practice Address - Fax:937-424-8518
Is Sole Proprietor?:No
Enumeration Date:2012-11-27
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.01820237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter