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General NPI Number Information
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NPI Number | 1326851205
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Entity Type | Individual
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Provider Name | JENNIFER E CHANDLER
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Gender | Female
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 731 MAIN ST
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City | MONROE
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State | CT
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Zip | 06468-2872
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Country | US
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Telephone | 203-261-7090
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Fax |
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Provider Business Mailing Address
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Address Line | 65 HILLTOP DR
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City | SOUTHPORT
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State | CT
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Zip | 06890-1206
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Country | US
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Telephone | 203-243-2878
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14876
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License Number State | CT
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