Provider Demographics
NPI:1205689668
Name:CHELSEA PEDIATRIC THERAPY CENTER, PLLC
Entity type:Organization
Organization Name:CHELSEA PEDIATRIC THERAPY CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINN-KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:734-250-4250
Mailing Address - Street 1:1307 S MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1479
Mailing Address - Country:US
Mailing Address - Phone:734-489-9414
Mailing Address - Fax:
Practice Address - Street 1:1307 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1479
Practice Address - Country:US
Practice Address - Phone:734-489-9414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty