Provider Demographics
NPI:1538532858
Name:NEILSON, CHELSEA ANN (PTA)
Entity type:Individual
Prefix:MISS
First Name:CHELSEA
Middle Name:ANN
Last Name:NEILSON
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18302 MOSCOW ST SW
Mailing Address - Street 2:
Mailing Address - City:BARTON
Mailing Address - State:MD
Mailing Address - Zip Code:21521-2045
Mailing Address - Country:US
Mailing Address - Phone:301-463-2048
Mailing Address - Fax:
Practice Address - Street 1:18302 MOSCOW ST SW
Practice Address - Street 2:
Practice Address - City:BARTON
Practice Address - State:MD
Practice Address - Zip Code:21521-2045
Practice Address - Country:US
Practice Address - Phone:301-463-2048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA4369225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant