Provider Demographics
NPI:1447812227
Name:MUSCOE, CHELSEA RAE (BCBA)
Entity type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:RAE
Last Name:MUSCOE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2353 BADGER STREET
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-2303
Mailing Address - Country:US
Mailing Address - Phone:906-273-1121
Mailing Address - Fax:906-225-6706
Practice Address - Street 1:2353 BADGER STREET
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-2303
Practice Address - Country:US
Practice Address - Phone:906-273-1121
Practice Address - Fax:906-225-6706
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7401001821103K00000X
WI302-140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst