Provider Demographics
NPI:1295493294
Name:MINIET, CHANTAL (RMHC)
Entity type:Individual
Prefix:
First Name:CHANTAL
Middle Name:
Last Name:MINIET
Suffix:
Gender:F
Credentials:RMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3936 HAVERFORD AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2812
Mailing Address - Country:US
Mailing Address - Phone:305-610-7913
Mailing Address - Fax:
Practice Address - Street 1:3355 W 68TH ST APT 159
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-1743
Practice Address - Country:US
Practice Address - Phone:305-610-7913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19930101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health