Provider Demographics
NPI:1447483508
Name:CHEVALIER, BRENDA KAY (MA)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:KAY
Last Name:CHEVALIER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 OHIO ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4543
Mailing Address - Country:US
Mailing Address - Phone:360-392-2838
Mailing Address - Fax:360-527-8999
Practice Address - Street 1:112 OHIO ST
Practice Address - Street 2:SUITE 103
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4543
Practice Address - Country:US
Practice Address - Phone:360-392-2838
Practice Address - Fax:360-527-8999
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004049101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health