Provider Demographics
NPI:1265056766
Name:CHANEY, CHEYENNE BROOKE (MA ED, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:BROOKE
Last Name:CHANEY
Suffix:
Gender:F
Credentials:MA ED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 MEDPARK DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-2734
Mailing Address - Country:US
Mailing Address - Phone:606-679-1761
Mailing Address - Fax:606-678-0971
Practice Address - Street 1:175 MEDPARK DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2734
Practice Address - Country:US
Practice Address - Phone:606-679-1761
Practice Address - Fax:606-678-0971
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist