Provider Demographics
NPI:1982901401
Name:HAGGERTON, CHELSEA (OT)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:HAGGERTON
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 1:1701 KIRBY AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-6138
Mailing Address - Country:US
Mailing Address - Phone:806-793-3900
Mailing Address - Fax:806-793-3937
Practice Address - Street 1:4601 66TH ST STE D
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-4875
Practice Address - Country:US
Practice Address - Phone:806-793-3900
Practice Address - Fax:806-793-3937
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114021225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist