Provider Demographics
NPI:1457658452
Name:CHAFFIN, AMANDA E (BS)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:E
Last Name:CHAFFIN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:E
Other - Last Name:GARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:1570 45 1/2 RD
Mailing Address - Street 2:
Mailing Address - City:DE BEQUE
Mailing Address - State:CO
Mailing Address - Zip Code:81630-9633
Mailing Address - Country:US
Mailing Address - Phone:970-424-4099
Mailing Address - Fax:
Practice Address - Street 1:1570 45 1/2 RD
Practice Address - Street 2:
Practice Address - City:DE BEQUE
Practice Address - State:CO
Practice Address - Zip Code:81630-9633
Practice Address - Country:US
Practice Address - Phone:970-424-4099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst