Provider Demographics
NPI:1619379930
Name:CHAPMAN, JOLYNNE CHAPMAN (MAMFC)
Entity Type:Individual
Prefix:MRS
First Name:JOLYNNE
Middle Name:CHAPMAN
Last Name:CHAPMAN
Suffix:
Gender:F
Credentials:MAMFC
Other - Prefix:MISS
Other - First Name:JOLYNNE
Other - Middle Name:CHRISTINE
Other - Last Name:FROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAMFC
Mailing Address - Street 1:312 N VINE ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-1342
Mailing Address - Country:US
Mailing Address - Phone:386-249-0855
Mailing Address - Fax:
Practice Address - Street 1:312 N VINE ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:TN
Practice Address - Zip Code:37398-1342
Practice Address - Country:US
Practice Address - Phone:386-249-0855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist