Provider Demographics
NPI:1881108355
Name:KIRBY, CHELSEA ROSE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ROSE
Last Name:KIRBY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1858 CINDY LN
Mailing Address - Street 2:
Mailing Address - City:HATFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19440-3220
Mailing Address - Country:US
Mailing Address - Phone:267-663-9531
Mailing Address - Fax:
Practice Address - Street 1:1858 CINDY LN
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:PA
Practice Address - Zip Code:19440-3220
Practice Address - Country:US
Practice Address - Phone:267-663-9531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-20
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASLO13776235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist