Most Relevant Information
Provider Data
| NPI Number: | 1003641879 |
| Provider Name: | TYAISHA CHAVERS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/03/2024 |
| Last Updated: | 09/03/2024 |
Provider Practice Location
7939 HONEYGO BLVD STE 127
NOTTINGHAM
MD
212365905
Practice Location Phone/Fax
| Phone: | 8667278274 |
| Fax: |
Provider Mailing Location
2550 N HOLLYWOOD WAY STE 301
BURBANK
CA
915055025
Provider Mailing Phone/Fax
| Phone: | 8667278274 |
| Fax: |