Provider Demographics
NPI:1568890630
Name:CHALLENGER, KEMLYE SHERRI (MS SPED/ ABA THER)
Entity Type:Individual
Prefix:
First Name:KEMLYE
Middle Name:SHERRI
Last Name:CHALLENGER
Suffix:
Gender:F
Credentials:MS SPED/ ABA THER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 AVENUE T
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5034
Mailing Address - Country:US
Mailing Address - Phone:347-703-9994
Mailing Address - Fax:
Practice Address - Street 1:4212 AVENUE T
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5034
Practice Address - Country:US
Practice Address - Phone:347-703-9994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-28
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No252Y00000XAgenciesEarly Intervention Provider Agency