Provider Demographics
NPI:1093547309
Name:MAY, CHLOE IONNA
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:IONNA
Last Name:MAY
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 1:9905 FALL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-4804
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:203 W BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:FAIRLAND
Practice Address - State:IN
Practice Address - Zip Code:46126-9426
Practice Address - Country:US
Practice Address - Phone:803-446-9753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician