Provider Demographics
NPI:1104565902
Name:O'BOYLE, CHELSEA ANNE (OTR/L)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ANNE
Last Name:O'BOYLE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4723 KNIGHTS BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-5335
Mailing Address - Country:US
Mailing Address - Phone:559-960-6545
Mailing Address - Fax:
Practice Address - Street 1:4723 KNIGHTS BRANCH DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-5335
Practice Address - Country:US
Practice Address - Phone:559-960-6545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122331225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist