Provider Demographics
NPI:1205274404
Name:PETERSON, CHELSEA CATHLEEN (AUD)
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:CATHLEEN
Last Name:PETERSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:CATHLEEN
Other - Last Name:COMEAUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6630 S MCCARRAN BLVD
Mailing Address - Street 2:STE B16
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6136
Mailing Address - Country:US
Mailing Address - Phone:775-323-5566
Mailing Address - Fax:775-323-5667
Practice Address - Street 1:6630 S MCCARRAN BLVD STE B16
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6136
Practice Address - Country:US
Practice Address - Phone:775-323-5566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-1572231HA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner