Provider Demographics
NPI:1780211094
Name:ZIGRAY, CHIARA ANN
Entity Type:Individual
Prefix:
First Name:CHIARA
Middle Name:ANN
Last Name:ZIGRAY
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 1:1375 HUNTINGTON LN
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:PA
Mailing Address - Zip Code:18414-9164
Mailing Address - Country:US
Mailing Address - Phone:570-903-2058
Mailing Address - Fax:
Practice Address - Street 1:1375 HUNTINGTON LN
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:PA
Practice Address - Zip Code:18414-9164
Practice Address - Country:US
Practice Address - Phone:570-903-2058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-25
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YS0200X
PAPC010808101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool