Provider Demographics
NPI:1144574666
Name:SRYGLER, CHIFFON RENA (IECE/MASTERS)
Entity Type:Individual
Prefix:MRS
First Name:CHIFFON
Middle Name:RENA
Last Name:SRYGLER
Suffix:
Gender:F
Credentials:IECE/MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 PRICEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BONNIEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42713-8448
Mailing Address - Country:US
Mailing Address - Phone:270-531-3987
Mailing Address - Fax:844-688-4227
Practice Address - Street 1:200 PRICEVILLE RD
Practice Address - Street 2:
Practice Address - City:BONNIEVILLE
Practice Address - State:KY
Practice Address - Zip Code:42713
Practice Address - Country:US
Practice Address - Phone:270-531-3987
Practice Address - Fax:844-688-4227
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-06
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY000060968222Q00000X
222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist