Provider Demographics
NPI:1407563943
Name:CHAPPLE, TATIANA DANIELLE (LAMFT)
Entity Type:Individual
Prefix:
First Name:TATIANA
Middle Name:DANIELLE
Last Name:CHAPPLE
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 PEACHWOOD CIR NE APT 2208
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-8037
Mailing Address - Country:US
Mailing Address - Phone:614-203-4466
Mailing Address - Fax:
Practice Address - Street 1:3720 CHAMBLEE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-2064
Practice Address - Country:US
Practice Address - Phone:678-802-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAMFT000565106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist