Provider Demographics
NPI:1083253249
Name:MCPHATTER, CHRISCHANNE
Entity Type:Individual
Prefix:
First Name:CHRISCHANNE
Middle Name:
Last Name:MCPHATTER
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 1:1717 MONTELLO AVE NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-7822
Mailing Address - Country:US
Mailing Address - Phone:202-713-2736
Mailing Address - Fax:
Practice Address - Street 1:1717 MONTELLO AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7822
Practice Address - Country:US
Practice Address - Phone:202-210-9842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-04
Last Update Date:2020-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician