Provider Demographics
NPI:1760258404
Name:JANVIER, CHACHOUNE
Entity Type:Individual
Prefix:
First Name:CHACHOUNE
Middle Name:
Last Name:JANVIER
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 1:4110 W GIRARD AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-1011
Mailing Address - Country:US
Mailing Address - Phone:908-248-1547
Mailing Address - Fax:
Practice Address - Street 1:4110 W GIRARD AVE APT 2
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-1011
Practice Address - Country:US
Practice Address - Phone:908-248-1547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-04
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician