Healthcare Provider Details

I. General information

NPI: 1437514932
Provider Name (Legal Business Name): DWANNA CHATMAN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2015
Last Update Date: 12/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 BIENVILLE SQ
NATCHITOCHES LA
71457-5069
US

IV. Provider business mailing address

113 BIENVILLE SQ
NATCHITOCHES LA
71457-5069
US

V. Phone/Fax

Practice location:
  • Phone: 318-238-4030
  • Fax: 318-787-5768
Mailing address:
  • Phone: 318-238-4030
  • Fax: 318-787-5768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: