Provider Demographics
NPI:1285150284
Name:HARDEN, CHELSEA (CTRS)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:
Last Name:HARDEN
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 E CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-2705
Mailing Address - Country:US
Mailing Address - Phone:818-613-6394
Mailing Address - Fax:
Practice Address - Street 1:21152 N 22ND ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-5513
Practice Address - Country:US
Practice Address - Phone:818-613-6394
Practice Address - Fax:818-613-6394
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
60987OtherNATIONAL COUNCIL FOR THERAPEUTIC RECREATION CERIFICATION