Provider Demographics
NPI:1265047112
Name:LANDRY, CHELSEA MAUREEN (OTD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:MAUREEN
Last Name:LANDRY
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 BEECHCREST CT APT 104
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-6638
Mailing Address - Country:US
Mailing Address - Phone:908-399-9735
Mailing Address - Fax:
Practice Address - Street 1:200 W 12TH ST STE A1-100
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-4771
Practice Address - Country:US
Practice Address - Phone:540-941-5501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119008631225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist