Provider Demographics
NPI:1710301999
Name:MANN, CHANTEL
Entity Type:Individual
Prefix:MISS
First Name:CHANTEL
Middle Name:
Last Name:MANN
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 1:14471 N HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72833-6561
Mailing Address - Country:US
Mailing Address - Phone:517-607-9108
Mailing Address - Fax:
Practice Address - Street 1:14471 N HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:AR
Practice Address - Zip Code:72833-6561
Practice Address - Country:US
Practice Address - Phone:517-607-9108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-09
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant