Most Relevant Information
Provider Data
| NPI Number: | 1003499088 |
| Provider Name: | CHANIDA TREVATHAN RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/28/2021 |
| Last Updated: | 04/28/2021 |
Provider Practice Location
1964 ASHLEY RIVER RD UNIT 80901B
CHARLESTON
SC
294161637
Practice Location Phone/Fax
| Phone: | 8652874163 |
| Fax: | 8888084249 |
Provider Mailing Location
1964 ASHLEY RIVER RD UNIT 80901B
CHARLESTON
SC
294161637
Provider Mailing Phone/Fax
| Phone: | 8652874163 |
| Fax: | 8888084249 |