Provider Demographics
NPI:1538767272
Name:CHASE, KELSEY M
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:M
Last Name:CHASE
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 1:333 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELIOT
Mailing Address - State:ME
Mailing Address - Zip Code:03903-2286
Mailing Address - Country:US
Mailing Address - Phone:603-714-8738
Mailing Address - Fax:
Practice Address - Street 1:333 MAIN ST
Practice Address - Street 2:
Practice Address - City:ELIOT
Practice Address - State:ME
Practice Address - Zip Code:03903-2286
Practice Address - Country:US
Practice Address - Phone:603-714-8738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist