Healthcare Provider Details

I. General information

NPI: 1760247761
Provider Name (Legal Business Name): CHRISTY CHANDLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 E US HIGHWAY 66
EL RENO OK
73036-9125
US

IV. Provider business mailing address

9517 SW 25TH ST
OKLAHOMA CITY OK
73128-4947
US

V. Phone/Fax

Practice location:
  • Phone: 405-424-7711
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number22571
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: