Provider Demographics
NPI:1053036681
Name:CHANEY, ALLYEHA KRISTINE
Entity type:Individual
Prefix:
First Name:ALLYEHA
Middle Name:KRISTINE
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 1:20807 KALAMAZOO RD
Mailing Address - Street 2:
Mailing Address - City:BIG RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49307-8837
Mailing Address - Country:US
Mailing Address - Phone:231-912-0414
Mailing Address - Fax:
Practice Address - Street 1:10327 GRAND RIVER RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-6500
Practice Address - Country:US
Practice Address - Phone:800-787-5118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician