Provider Demographics
NPI:1255815650
Name:JOHN-TOUSSAINT, CHAUNTAE CHE (MSCCC-SLP)
Entity type:Individual
Prefix:
First Name:CHAUNTAE
Middle Name:CHE
Last Name:JOHN-TOUSSAINT
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 HAYES ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-5554
Mailing Address - Country:US
Mailing Address - Phone:301-966-7976
Mailing Address - Fax:
Practice Address - Street 1:5100 HAYES ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5554
Practice Address - Country:US
Practice Address - Phone:301-966-7976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSLP001204235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist