Joseph Donzell Chaney Jr., MED CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Hahira, GA
NPI 1871528604 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1871528604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 3518 (GA)
- Practice address
- 4400 Woodfield Dr
Hahira, GA 31632-3110 - Phone
- (229) 506-7565
- Fax
- (229) 506-7565
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3518 | GA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3518 | GA | Yes |
Addresses
Primary practice location
4400 Woodfield Dr
Hahira, GA 31632-3110
Mailing address
4400 Woodfield Dr
Hahira, GA 31632-3110
Phone (229) 506-7565
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00826548A | Medicaid | GA |
Other providers in Hahira, GA
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- Hugh Michael Chancy
- Patrick Chancy
- Tina W Chancy
- Danielle Felicia Chappell
- Lindsey Baker Childress
- Sunari Cody
- Haley Clarke Cox
- Billie Jewell Creech
All providers in Hahira, GA · Speech-Language Pathologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.