Provider Demographics
NPI:1457901274
Name:STARIN, CHELSEY (OT)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:STARIN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2064 WYANDOTTE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-6136
Mailing Address - Country:US
Mailing Address - Phone:440-572-2737
Mailing Address - Fax:
Practice Address - Street 1:12234 COOPERS RUN
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44149-9238
Practice Address - Country:US
Practice Address - Phone:440-572-2737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH010771225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist