Provider Demographics
NPI:1255658597
Name:CHAND, MINEELA JAYAPRIYA (BSC, MDIV, LMFT)
Entity Type:Individual
Prefix:
First Name:MINEELA
Middle Name:JAYAPRIYA
Last Name:CHAND
Suffix:
Gender:F
Credentials:BSC, MDIV, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 ANTHONY WAYNE DR
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-1325
Mailing Address - Country:US
Mailing Address - Phone:610-551-8203
Mailing Address - Fax:
Practice Address - Street 1:1455 ANTHONY WAYNE DR
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-1325
Practice Address - Country:US
Practice Address - Phone:610-551-8203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000582106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist