Provider Demographics
NPI:1750073912
Name:CHANEY, ADRIENNE MILAGROS
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:MILAGROS
Last Name:CHANEY
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 1:176 BRICKTON VILLAGE CIR UNIT 101
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-8830
Mailing Address - Country:US
Mailing Address - Phone:941-456-3649
Mailing Address - Fax:
Practice Address - Street 1:176 BRICKTON VILLAGE CIR UNIT 101
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:NC
Practice Address - Zip Code:28732-8830
Practice Address - Country:US
Practice Address - Phone:941-456-3649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health