Provider Demographics
NPI:1174322069
Name:CHINN, MALIYAH DEVON
Entity type:Individual
Prefix:
First Name:MALIYAH
Middle Name:DEVON
Last Name:CHINN
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 1:1998 BARRET CT SUITE A
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-7527
Mailing Address - Country:US
Mailing Address - Phone:812-431-2598
Mailing Address - Fax:
Practice Address - Street 1:1998 BARRET CT SUITE A
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-7527
Practice Address - Country:US
Practice Address - Phone:812-431-2598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician