Provider Demographics
NPI:1538484027
Name:MCNAIR, CHEVELLE (OT)
Entity Type:Individual
Prefix:MS
First Name:CHEVELLE
Middle Name:
Last Name:MCNAIR
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 LAMOTTE COURT
Mailing Address - Street 2:
Mailing Address - City:LAUREL SPRINGS
Mailing Address - State:NJ
Mailing Address - Zip Code:08021
Mailing Address - Country:US
Mailing Address - Phone:856-302-5414
Mailing Address - Fax:856-302-5287
Practice Address - Street 1:2 LA MOTTE CT
Practice Address - Street 2:
Practice Address - City:LINDENWOLD
Practice Address - State:NJ
Practice Address - Zip Code:08021-6863
Practice Address - Country:US
Practice Address - Phone:856-302-5414
Practice Address - Fax:856-302-5287
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00326400225X00000X
PAOC008890225X00000X
DEU1-0000831225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist