Provider Demographics
NPI:1982374146
Name:CHAMBERS, ABIGAYLE (BCBA)
Entity Type:Individual
Prefix:
First Name:ABIGAYLE
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6725 HICKORY TRACE CIR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3655
Mailing Address - Country:US
Mailing Address - Phone:865-684-9100
Mailing Address - Fax:
Practice Address - Street 1:6725 HICKORY TRACE CIR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3655
Practice Address - Country:US
Practice Address - Phone:865-684-9100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN743103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst