Provider Demographics
NPI:1982292066
Name:ROSSIGNOL, CHLOE MARIE
Entity type:Individual
Prefix:
First Name:CHLOE
Middle Name:MARIE
Last Name:ROSSIGNOL
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:PO BOX 244
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:KS
Mailing Address - Zip Code:67654-0244
Mailing Address - Country:US
Mailing Address - Phone:785-877-0550
Mailing Address - Fax:
Practice Address - Street 1:1107 E 13TH ST
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2411
Practice Address - Country:US
Practice Address - Phone:785-675-0443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
17-03738225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist