Provider Demographics
NPI:1558654236
Name:PEMBERTON, CHANDLER PERA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHANDLER
Middle Name:PERA
Last Name:PEMBERTON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 HILLSBORO PIKE APT 2
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-1343
Mailing Address - Country:US
Mailing Address - Phone:615-477-1830
Mailing Address - Fax:
Practice Address - Street 1:301 WOLVERINE TRL STE 201
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5656
Practice Address - Country:US
Practice Address - Phone:615-220-5796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist