Individual
CHYNA DEWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5811 BRITISH SQUARE DR APT E, WINSTON SALEM, NC 27105-1114
(336) 230-5053
Mailing address
5811 BRITISH SQUARE DR APT E, WINSTON SALEM, NC 27105-1114
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/30/2022
Last updated
06/30/2022
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