Provider Demographics
NPI:1316777360
Name:CHAMBERS, ALYVIA
Entity type:Individual
Prefix:
First Name:ALYVIA
Middle Name:
Last Name:CHAMBERS
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:WREN
Other - Middle Name:
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3535 MOUNTAIN CREEK RD APT 407
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-6715
Mailing Address - Country:US
Mailing Address - Phone:865-776-8577
Mailing Address - Fax:
Practice Address - Street 1:3535 MOUNTAIN CREEK RD APT 407
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37415-6715
Practice Address - Country:US
Practice Address - Phone:865-776-8577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst