Doctor Name: | TIERA CHENAULT |
NPI Number: | 1891127445 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 0026A |
Business Practice Address: | 21515 Zion Rd Brookeville, MD - 208331009 |
Business Phone Number: | 2409122220 |
Business Fax Number: | |
Mailing Address: | 414 Starwood Dr, Apt F GLEN BURNIE |
State: | MD |
Postal Code: | 210616020 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/06/2013 |
NPI Last Update Date: | 08/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2355S0801X |
License Number: | 0026A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | Speech-Language Assistant |
Taxonomy Definition: |