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General NPI Number Information
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NPI Number | 1700419645
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Entity Type | Individual
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Provider Name | DEMITRA CHANDLER
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Gender | Female
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 92 MAIN ST
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City | WARRENTON
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State | VA
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Zip | 20186-3366
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Country | US
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Telephone | 703-981-2399
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Fax |
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Provider Business Mailing Address
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Address Line | 702 RIVER CREST WAY
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City | FREDERICKSBURG
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State | VA
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Zip | 22405
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Country | US
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Telephone | 703-981-2399
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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 |
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License Number State |
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