Provider Demographics
NPI:1760720817
Name:MCCHESNEY, CLAIRE (AUD)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:MCCHESNEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 HIGHLAND AVENUE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-2557
Mailing Address - Country:US
Mailing Address - Phone:203-272-4512
Mailing Address - Fax:203-272-4517
Practice Address - Street 1:415 HIGHLAND AVENUE
Practice Address - Street 2:SUITE 2
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2557
Practice Address - Country:US
Practice Address - Phone:203-272-4512
Practice Address - Fax:203-272-4517
Is Sole Proprietor?:No
Enumeration Date:2013-01-24
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000520231HA2400X, 231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000520OtherLICENSE