Provider Demographics
NPI:1811613656
Name:CHATMAN, CAMILLE ANDREA
Entity type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:ANDREA
Last Name:CHATMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CAMILLE
Other - Middle Name:ANDREA
Other - Last Name:VASSEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9301 NW 55TH ST
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-7789
Mailing Address - Country:US
Mailing Address - Phone:954-300-9901
Mailing Address - Fax:
Practice Address - Street 1:9301 NW 55TH ST
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7789
Practice Address - Country:US
Practice Address - Phone:954-300-9901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20502235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist