Provider Demographics
NPI:1902670904
Name:CHAMBLESS, KADEY
Entity Type:Individual
Prefix:
First Name:KADEY
Middle Name:
Last Name:CHAMBLESS
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 437287
Mailing Address - Street 2:
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-7287
Mailing Address - Country:US
Mailing Address - Phone:725-400-6316
Mailing Address - Fax:
Practice Address - Street 1:75-5591 PALANI RD
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-3631
Practice Address - Country:US
Practice Address - Phone:808-556-3120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician