Provider Demographics
NPI:1871202945
Name:CHAPIN, COLLIN
Entity type:Individual
Prefix:
First Name:COLLIN
Middle Name:
Last Name:CHAPIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 SHANNOCK RD
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-4746
Mailing Address - Country:US
Mailing Address - Phone:203-807-3003
Mailing Address - Fax:
Practice Address - Street 1:105 FRANKLIN ST UNIT 5/6
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-3179
Practice Address - Country:US
Practice Address - Phone:401-596-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTHIS00424237700000X
RIHAD00330237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist