Provider Demographics
NPI:1366953606
Name:HOLMES, CHELSEA DANIELLE (MOT, OTR/L)
Entity type:Individual
Prefix:MISS
First Name:CHELSEA
Middle Name:DANIELLE
Last Name:HOLMES
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:DANIELLE
Other - Last Name:HURTIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5800 E SKELLY DR STE 402
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-6441
Mailing Address - Country:US
Mailing Address - Phone:918-497-1068
Mailing Address - Fax:
Practice Address - Street 1:5800 E SKELLY DR STE 402
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-6441
Practice Address - Country:US
Practice Address - Phone:918-497-1068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1903225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist