Provider Demographics
NPI:1144697582
Name:CHALONEC, LYDIA (MED)
Entity type:Individual
Prefix:MS
First Name:LYDIA
Middle Name:
Last Name:CHALONEC
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8254 GOLDEN CHICKASAW CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5162
Mailing Address - Country:US
Mailing Address - Phone:407-227-0162
Mailing Address - Fax:
Practice Address - Street 1:8254 GOLDEN CHICKASAW CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-5162
Practice Address - Country:US
Practice Address - Phone:407-227-0162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-01
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker