Individual provider · Type 1 NPI

Kellie Derae Chestnut, ITDS, M.A.E.

Developmental Therapist · Jacksonville, FL

NPI number 1902990328 Active

Practice location

910 N Jefferson St
Jacksonville, FL 32209-6810

Call (270) 847-5723 Map

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist Primary 222Q00000XNone listed
Case Manager/Care Coordinator 171M00000XNone listed

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

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About NPI 1902990328

Kellie Derae Chestnut, ITDS, M.A.E.'s National Provider Identifier is 1902990328, issued on Oct 2, 2006. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Jacksonville, FL. The record was last updated on Mar 13, 2019.