Provider Demographics
NPI:1578154365
Name:CHAMPION, NEENA LEE (MSW)
Entity Type:Individual
Prefix:
First Name:NEENA
Middle Name:LEE
Last Name:CHAMPION
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 1:2087 GALE AVE SW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32908-1418
Mailing Address - Country:US
Mailing Address - Phone:321-482-4149
Mailing Address - Fax:
Practice Address - Street 1:2087 GALE AVE SW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32908-1418
Practice Address - Country:US
Practice Address - Phone:321-482-4149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker