Provider Demographics
NPI:1649048737
Name:WIKLE, CHELSEA LEIGH (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:LEIGH
Last Name:WIKLE
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W BELT LINE RD # C110
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-6015
Mailing Address - Country:US
Mailing Address - Phone:469-593-7448
Mailing Address - Fax:
Practice Address - Street 1:701 W BELT LINE RD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-6015
Practice Address - Country:US
Practice Address - Phone:469-593-7448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81064231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist