Provider Demographics
NPI:1841913944
Name:TONIA, CHANTE (ND)
Entity type:Individual
Prefix:
First Name:CHANTE
Middle Name:
Last Name:TONIA
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:CHANTE
Other - Middle Name:
Other - Last Name:CALLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:49 MARKET ST STE 6
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-4849
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:49 MARKET ST STE 6
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-4849
Practice Address - Country:US
Practice Address - Phone:201-881-9563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000513175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty