Healthcare Provider Details

I. General information

NPI: 1689698722
Provider Name (Legal Business Name): CYNTHIA C CHAPMAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 04/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RR 1 BOX 67
HARLEM MT
59526-9705
US

IV. Provider business mailing address

RR 1 BOX 67
HARLEM MT
59526-9705
US

V. Phone/Fax

Practice location:
  • Phone: 406-353-3163
  • Fax: 406-353-3308
Mailing address:
  • Phone: 406-353-3163
  • Fax: 406-353-3308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4791
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: