Healthcare Provider Details

I. General information

NPI: 1144148800
Provider Name (Legal Business Name): ANDREA CHANEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9505 REISTERSTOWN RD
OWINGS MILLS MD
21117-4451
US

IV. Provider business mailing address

546 UNIONTOWN RD
WESTMINSTER MD
21158-4242
US

V. Phone/Fax

Practice location:
  • Phone: 317-750-2158
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: