Provider Demographics
NPI:1093482382
Name:CHACON, AALIYAH J
Entity type:Individual
Prefix:MRS
First Name:AALIYAH
Middle Name:J
Last Name:CHACON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 BURLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:OPA LOCKA
Mailing Address - State:FL
Mailing Address - Zip Code:33054-3924
Mailing Address - Country:US
Mailing Address - Phone:786-630-7903
Mailing Address - Fax:
Practice Address - Street 1:681 BURLINGTON ST
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-3924
Practice Address - Country:US
Practice Address - Phone:786-630-7903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician