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Individual

CHAD CHRISTOPHER CHIEFFALLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.ED, LMFT, BCBA

Contact information

Practice address
264 BERGAMOT LOOP, DAVENPORT, FL 33837-7721
(352) 223-1500
Mailing address
264 BERGAMOT LOOP, DAVENPORT, FL 33837-7721
(352) 223-1500

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-22-59812
FL
106H00000X
Marriage & Family Therapist
Primary
MT4599
FL
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
07/02/2018
Last updated
06/13/2023
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