Provider Demographics
NPI:1194826883
Name:CHELEDNIK, TAMMY (MS)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:
Last Name:CHELEDNIK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 JUNCTION RD
Mailing Address - Street 2:THE CHILD & FAMILY INSTITUTE OF FAIRFIELD COUNTY
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-3457
Mailing Address - Country:US
Mailing Address - Phone:203-740-7296
Mailing Address - Fax:
Practice Address - Street 1:33 JUNCTION RD
Practice Address - Street 2:THE CHILD & FAMILY INSTITUTE OF FAIRFIELD COUNTY
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-3457
Practice Address - Country:US
Practice Address - Phone:203-740-7296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000973101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor