Provider Demographics
NPI:1659074649
Name:SPENCER, CHIANE CHARDE
Entity Type:Individual
Prefix:
First Name:CHIANE
Middle Name:CHARDE
Last Name:SPENCER
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 1:9 PROFESSIONAL PARK DR STE A
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4144
Mailing Address - Country:US
Mailing Address - Phone:832-240-4563
Mailing Address - Fax:
Practice Address - Street 1:9 PROFESSIONAL PARK DR STE A
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4144
Practice Address - Country:US
Practice Address - Phone:832-240-4563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician