Provider Demographics
NPI:1932482783
Name:VANEK, CHELSIE ANDREA
Entity Type:Individual
Prefix:MS
First Name:CHELSIE
Middle Name:ANDREA
Last Name:VANEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 797
Mailing Address - Street 2:
Mailing Address - City:VIAN
Mailing Address - State:OK
Mailing Address - Zip Code:74962-0797
Mailing Address - Country:US
Mailing Address - Phone:940-781-7702
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 1 EVENING SHADE ROAD
Practice Address - Street 2:
Practice Address - City:VIAN
Practice Address - State:OK
Practice Address - Zip Code:74962
Practice Address - Country:US
Practice Address - Phone:918-774-6201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist