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NPI Code Detail

MEDICARE: NEVAEH CHANIEL CHAVERS BEHAVIOR TECHNICIAN

MEDICARE: NEVAEH CHANIEL CHAVERS BEHAVIOR TECHNICIAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianGA

General Provider Information

NPI Number : 1154114619
Entity Type Code : Individual
Provider Name (Legal Business Name) : NEVAEH CHANIEL CHAVERS BEHAVIOR TECHNICIAN
Provider Business Mailing Address
First Line : 2000 JAMES JACKSON PKWY NW APT 2404
Second Line :
City : ATLANTA
State : GA
Zip : 30318-1025
Country : US
Telephone Number : 678-308-8608
Fax Number :
Provider Business Practice Location Address
First Line : 3372 PEACHTREE RD NE STE 115
Second Line :
City : ATLANTA
State : GA
Zip : 30326-1963
Country : US
Telephone Number : 404-574-6489
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2025
Last Update Date : 08/27/2025

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Directions to “ NEVAEH CHANIEL CHAVERS BEHAVIOR TECHNICIAN” Practice Location

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