Provider Demographics
NPI:1992135750
Name:ROSE, CHELSEA (MS/OTR)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:ROSE
Suffix:
Gender:F
Credentials:MS/OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1332 VILLAGE PARK CT
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-1757
Mailing Address - Country:US
Mailing Address - Phone:720-402-1977
Mailing Address - Fax:
Practice Address - Street 1:1332 VILLAGE PARK CT
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-1757
Practice Address - Country:US
Practice Address - Phone:720-402-1977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0003594225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist