Provider Demographics
NPI:1073234415
Name:CHANDLER, BIANCA DUBRIEL
Entity Type:Individual
Prefix:
First Name:BIANCA
Middle Name:DUBRIEL
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 MARILYN DR APT 17
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-4475
Mailing Address - Country:US
Mailing Address - Phone:225-603-2387
Mailing Address - Fax:
Practice Address - Street 1:2460 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-2445
Practice Address - Country:US
Practice Address - Phone:225-223-9529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator