Healthcare Provider Details

I. General information

NPI: 1467720508
Provider Name (Legal Business Name): ANNA CHUNEYEVA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2011
Last Update Date: 02/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 WASHINGTON ST SUITE 304
HOLLYWOOD FL
33021-8256
US

IV. Provider business mailing address

3700 WASHINGTON ST SUITE 304
HOLLYWOOD FL
33021-8256
US

V. Phone/Fax

Practice location:
  • Phone: 954-961-1500
  • Fax: 954-961-7942
Mailing address:
  • Phone: 954-961-1500
  • Fax: 954-961-7942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY8394
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: