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1912238007 NPI number — CHANDA COTTINGHAM GRAVES PH.D.

NPI Number: 1912238007
Health Care Provider/Practitioner: CHANDA COTTINGHAM GRAVES PH.D.

Information about “1912238007” NPI (CHANDA COTTINGHAM GRAVES PH.D.) exists in 1912238007 in HTML format HTML  |  1912238007 in plain Text format TXT  |  1912238007 in PDF (Portable Document Format) PDF  |  1912238007 in an XML format XML  formats.

NPI Number : 1912238007 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1912238007",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GRAVES",
    "FirstName": "CHANDA",
    "MiddleName": "COTTINGHAM",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PH.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "COTTINGHAM",
    "OtherFirstName": "CHANDA",
    "OtherMiddleName": "ELISE",
    "OtherNamePrefix": "MISS",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "5301 GRAYSON PL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DECATUR",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30030-6420",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "404-298-5480",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "341 PONCE DE LEON AVE NE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ATLANTA",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30308-2012",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "404-616-9830",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/29/2010",
    "LastUpdateDate": "01/29/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103T00000X",
        "TaxonomyName": "Psychologist",
        "LicenseNumber": "PSY003350",
        "LicenseNumberStateCode": "GA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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