Provider Demographics
NPI:1538718051
Name:CARON, CHELSEA MAY
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MAY
Last Name:CARON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-3306
Mailing Address - Country:US
Mailing Address - Phone:978-846-9848
Mailing Address - Fax:
Practice Address - Street 1:207 AUTHORITY DR
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-6044
Practice Address - Country:US
Practice Address - Phone:978-696-5115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist