Provider Demographics
NPI:1114687548
Name:DUCKWORTH, CHANDRA DIONE (PHD)
Entity Type:Individual
Prefix:
First Name:CHANDRA
Middle Name:DIONE
Last Name:DUCKWORTH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5229 DIEPPE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77033-2636
Mailing Address - Country:US
Mailing Address - Phone:832-689-2852
Mailing Address - Fax:
Practice Address - Street 1:5229 DIEPPE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77033-2636
Practice Address - Country:US
Practice Address - Phone:832-689-2852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral