Provider Demographics
NPI:1790108645
Name:CHEVATEWA, DANIELLE (MSED)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:CHEVATEWA
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:574A 20TH ST
Mailing Address - Street 2:574-A 20 STREET
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-1049
Mailing Address - Country:US
Mailing Address - Phone:917-751-4804
Mailing Address - Fax:
Practice Address - Street 1:574A 20TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-1049
Practice Address - Country:US
Practice Address - Phone:917-751-4804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst