Healthcare Provider Details

I. General information

NPI: 1851217277
Provider Name (Legal Business Name): CHASITY DAWN ALLEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 CROW RUN
ROCKINGHAM NC
28379-4334
US

IV. Provider business mailing address

108 CROW RUN
ROCKINGHAM NC
28379-4334
US

V. Phone/Fax

Practice location:
  • Phone: 910-817-7009
  • Fax:
Mailing address:
  • Phone: 910-817-7009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number4484
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: