Provider Demographics
NPI:1467905844
Name:WILLIAM, CHANTE MONIQUE
Entity Type:Individual
Prefix:MS
First Name:CHANTE
Middle Name:MONIQUE
Last Name:WILLIAM
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 1:1701 ROCK SPRINGS DR APT 2019
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-3134
Mailing Address - Country:US
Mailing Address - Phone:702-386-0254
Mailing Address - Fax:
Practice Address - Street 1:801 S RANCHO DR
Practice Address - Street 2:SUITE D2
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3854
Practice Address - Country:US
Practice Address - Phone:702-386-0254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst