Provider Demographics
NPI:1174247704
Name:THOMPSON, CHELSEA (MS OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 MERLIN AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2520
Mailing Address - Country:US
Mailing Address - Phone:606-875-6830
Mailing Address - Fax:
Practice Address - Street 1:67 JACKS LN
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-6152
Practice Address - Country:US
Practice Address - Phone:606-425-4371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY280976225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist