Provider Demographics
NPI:1134660541
Name:CHANDLER, JENNIFER CORI
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CORI
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 1:74 LONG HILL RD
Mailing Address - Street 2:
Mailing Address - City:LEVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:01054-9752
Mailing Address - Country:US
Mailing Address - Phone:941-626-7758
Mailing Address - Fax:
Practice Address - Street 1:74 LONG HILL RD
Practice Address - Street 2:
Practice Address - City:LEVERETT
Practice Address - State:MA
Practice Address - Zip Code:01054-9752
Practice Address - Country:US
Practice Address - Phone:941-626-7758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health