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General NPI Number Information
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NPI Number | 1538219555
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Entity Type | Individual
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Provider Name | CHANDA CARMELA CORBETT PHD
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Gender | Female
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 05/12/2014
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Provider Practice Location Address
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Address Line | 3545 ELLICOTT MILLS DR SUITE 101
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City | ELLICOTT CITY
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State | MD
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Zip | 21043-4548
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Country | US
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Telephone | 603-591-0149
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Fax | 410-788-3220
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Provider Business Mailing Address
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Address Line | 1108 DANIELS AVERNUE
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City | GWYNN OAK
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State | MD
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Zip | 21207
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Country | US
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Telephone | 603-591-0149
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Fax | 410-788-3220
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 04648
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License Number State | MD
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