Provider Demographics
NPI:1508242702
Name:TUCHBAND, CHANELL (MSW)
Entity Type:Individual
Prefix:MS
First Name:CHANELL
Middle Name:
Last Name:TUCHBAND
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10701 CLEARY BLVD
Mailing Address - Street 2:APT 105
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-6018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:555 SW 12TH AVE
Practice Address - Street 2:STE 100
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33069-3500
Practice Address - Country:US
Practice Address - Phone:954-657-9748
Practice Address - Fax:954-901-2617
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor