Provider Demographics
NPI:1154025575
Name:PEREA, CHYANNE AMANDA (C HT, RRT)
Entity type:Individual
Prefix:MRS
First Name:CHYANNE
Middle Name:AMANDA
Last Name:PEREA
Suffix:
Gender:F
Credentials:C HT, RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 W IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-6649
Mailing Address - Country:US
Mailing Address - Phone:602-565-2421
Mailing Address - Fax:
Practice Address - Street 1:440 W IRONWOOD DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-6649
Practice Address - Country:US
Practice Address - Phone:602-565-2421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach