Provider Demographics
NPI:1376036475
Name:CHAPMAN, KASANDRA LEIGH
Entity Type:Individual
Prefix:MS
First Name:KASANDRA
Middle Name:LEIGH
Last Name:CHAPMAN
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:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:OH
Mailing Address - Zip Code:44099-0012
Mailing Address - Country:US
Mailing Address - Phone:440-563-1727
Mailing Address - Fax:
Practice Address - Street 1:12941 RAVENNA ROAD
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024
Practice Address - Country:US
Practice Address - Phone:440-286-7154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker