Provider Demographics
NPI:1518318179
Name:CHIANESE, CHRISTINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:CHIANESE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 HEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-1610
Mailing Address - Country:US
Mailing Address - Phone:301-366-4694
Mailing Address - Fax:
Practice Address - Street 1:101 HEDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1610
Practice Address - Country:US
Practice Address - Phone:301-366-4694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05724103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist