Provider Demographics
NPI:1750761227
Name:GRICE, CHATNEY RENICE (MS)
Entity type:Individual
Prefix:
First Name:CHATNEY
Middle Name:RENICE
Last Name:GRICE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12559 BEARSDALE DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-6069
Mailing Address - Country:US
Mailing Address - Phone:317-997-7546
Mailing Address - Fax:
Practice Address - Street 1:12559 BEARSDALE DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46235-6069
Practice Address - Country:US
Practice Address - Phone:317-997-7546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-31
Last Update Date:2015-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health