Provider Demographics
NPI:1326895681
Name:NANCE, CHANEL
Entity type:Individual
Prefix:
First Name:CHANEL
Middle Name:
Last Name:NANCE
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 1:4320 FLINT HILL DR APT 104
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5813
Mailing Address - Country:US
Mailing Address - Phone:410-929-1205
Mailing Address - Fax:
Practice Address - Street 1:1201 SEVEN LOCKS RD STE 360-77
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20854-2931
Practice Address - Country:US
Practice Address - Phone:410-929-1205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional