Provider Demographics
NPI:1417593393
Name:MILLER, CHELSEA BROOKE
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:BROOKE
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CHELSEA
Other - Middle Name:BROOKE
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:835 N LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:OH
Mailing Address - Zip Code:45875-1216
Mailing Address - Country:US
Mailing Address - Phone:419-523-4300
Mailing Address - Fax:419-523-6188
Practice Address - Street 1:835 N LOCUST ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:OH
Practice Address - Zip Code:45875-1216
Practice Address - Country:US
Practice Address - Phone:419-523-4300
Practice Address - Fax:419-523-6188
Is Sole Proprietor?:No
Enumeration Date:2019-11-26
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker