Provider Demographics
NPI:1962705277
Name:CHEVALIER, NOORAYNE E (MA, LLP, CACII, CGC)
Entity type:Individual
Prefix:
First Name:NOORAYNE
Middle Name:E
Last Name:CHEVALIER
Suffix:
Gender:F
Credentials:MA, LLP, CACII, CGC
Other - Prefix:
Other - First Name:NOORAYNE
Other - Middle Name:NORENE E
Other - Last Name:CHEVALIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LLP, CACII, CGC
Mailing Address - Street 1:19445 W WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-3361
Mailing Address - Country:US
Mailing Address - Phone:313-307-0088
Mailing Address - Fax:313-281-2235
Practice Address - Street 1:19445 W WARREN AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-3361
Practice Address - Country:US
Practice Address - Phone:313-307-0088
Practice Address - Fax:313-281-2235
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011017103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling