Provider Demographics
NPI:1386277200
Name:CHASSE, EIZABETH JEAN
Entity type:Individual
Prefix:
First Name:EIZABETH
Middle Name:JEAN
Last Name:CHASSE
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 1:57 AUDUBON RD
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-1713
Mailing Address - Country:US
Mailing Address - Phone:978-994-4468
Mailing Address - Fax:
Practice Address - Street 1:8 DALE ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01832-3407
Practice Address - Country:US
Practice Address - Phone:781-354-6184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician