Provider Demographics
NPI:1497779516
Name:CHANDLER, GAIL S (MA)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:S
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 PORTLAND RD
Mailing Address - Street 2:UINIT 44
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-6658
Mailing Address - Country:US
Mailing Address - Phone:207-985-6286
Mailing Address - Fax:207-967-8847
Practice Address - Street 1:62 PORTLAND RD
Practice Address - Street 2:UINIT 44
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6658
Practice Address - Country:US
Practice Address - Phone:207-985-6286
Practice Address - Fax:207-967-8847
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC2415101YP2500X
MEMF1750106H00000X
CT000341106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist