Healthcare Provider Details

I. General information

NPI: 1114869542
Provider Name (Legal Business Name): MISS NICHELLE LAVERA SNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 INDEPENDENCE PKWY STE 400
CHESAPEAKE VA
23320-5205
US

IV. Provider business mailing address

640 INDEPENDENCE PKWY STE 400
CHESAPEAKE VA
23320-5205
US

V. Phone/Fax

Practice location:
  • Phone: 757-267-9634
  • Fax: 757-215-2975
Mailing address:
  • Phone: 757-267-9634
  • Fax: 757-215-2975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: