Healthcare Provider Details

I. General information

NPI: 1376408294
Provider Name (Legal Business Name): CHAZNEY ROBERTS RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 SAND PEBBLE DR STE A&B
JACKSON TN
38305-7591
US

IV. Provider business mailing address

4273 INDEPENDENCE LOOP
LEXINGTON TN
38351-8009
US

V. Phone/Fax

Practice location:
  • Phone: 901-443-9146
  • 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: