Provider Demographics
NPI:1720709595
Name:MAPLES, CHELSEA MARIE
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MARIE
Last Name:MAPLES
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 1:640 N MARTIN AVE
Mailing Address - Street 2:
Mailing Address - City:KAHOKA
Mailing Address - State:MO
Mailing Address - Zip Code:63445-1065
Mailing Address - Country:US
Mailing Address - Phone:660-341-5682
Mailing Address - Fax:
Practice Address - Street 1:120 S JOHNSON ST
Practice Address - Street 2:
Practice Address - City:KAHOKA
Practice Address - State:MO
Practice Address - Zip Code:63445-1657
Practice Address - Country:US
Practice Address - Phone:660-727-2722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022026080225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist