Provider Demographics
NPI:1699471037
Name:FIZER, CHELSEA MORIAH
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MORIAH
Last Name:FIZER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 BIRD OF PARADISE DR
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-9390
Mailing Address - Country:US
Mailing Address - Phone:386-289-8926
Mailing Address - Fax:
Practice Address - Street 1:240 BIRD OF PARADISE DR
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-9390
Practice Address - Country:US
Practice Address - Phone:386-289-8926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician