Individual
CHELSEY PAINTER KISTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4016 RAINTREE RD # 100A, CHESAPEAKE, VA 23321-3700
(757) 488-2864
Mailing address
5013 LAKE CIR, PORTSMOUTH, VA 23703-5206
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202008724
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316051287
—
VA
Enumeration date
11/16/2018
Last updated
11/16/2018
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