Provider Demographics
NPI:1609674803
Name:DAVIS, CHELSEY MARIE
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:MARIE
Last Name:DAVIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CHELSEY
Other - Middle Name:MARIE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SADDLEMIRE
Mailing Address - Street 1:7 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-1847
Mailing Address - Country:US
Mailing Address - Phone:607-349-8264
Mailing Address - Fax:
Practice Address - Street 1:7 GRANT ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-1847
Practice Address - Country:US
Practice Address - Phone:607-349-8264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1085357252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency