Provider Demographics
NPI:1659858587
Name:ESCALANTE, CHLOE JANELLE
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:JANELLE
Last Name:ESCALANTE
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 1:511 OAKLAHOMA ST.
Mailing Address - Street 2:APT 2
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504
Mailing Address - Country:US
Mailing Address - Phone:907-306-8127
Mailing Address - Fax:
Practice Address - Street 1:511 OAKLAHOMA ST.
Practice Address - Street 2:APT 2
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504
Practice Address - Country:US
Practice Address - Phone:907-306-8127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation