Provider Demographics
NPI:1659626133
Name:CHAVEZ, MARIA DOLOROSA
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:DOLOROSA
Last Name:CHAVEZ
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 1:934 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4549
Mailing Address - Country:US
Mailing Address - Phone:484-887-8699
Mailing Address - Fax:
Practice Address - Street 1:934 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4549
Practice Address - Country:US
Practice Address - Phone:484-887-8699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health