Provider Demographics
NPI:1518641893
Name:HEMMINGWAY, CHELEE ANNETTE TICHEY
Entity Type:Individual
Prefix:
First Name:CHELEE
Middle Name:ANNETTE TICHEY
Last Name:HEMMINGWAY
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 1:794 BUTTON AVE APT 21
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-9557
Mailing Address - Country:US
Mailing Address - Phone:209-884-2493
Mailing Address - Fax:
Practice Address - Street 1:794 BUTTON AVE APT 21
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-9557
Practice Address - Country:US
Practice Address - Phone:209-884-2493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician