Provider Demographics
NPI:1457827362
Name:HALE, CHASIDY
Entity Type:Individual
Prefix:MRS
First Name:CHASIDY
Middle Name:
Last Name:HALE
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 1:4405 CANVASBACK CT
Mailing Address - Street 2:
Mailing Address - City:NORTH DINWIDDIE
Mailing Address - State:VA
Mailing Address - Zip Code:23803-6837
Mailing Address - Country:US
Mailing Address - Phone:804-721-1707
Mailing Address - Fax:
Practice Address - Street 1:4405 CANVASBACK CT
Practice Address - Street 2:
Practice Address - City:NORTH DINWIDDIE
Practice Address - State:VA
Practice Address - Zip Code:23803-6837
Practice Address - Country:US
Practice Address - Phone:804-721-1707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management