Provider Demographics
NPI:1639932809
Name:CHANDLER, LILIANA
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LILIANA
Other - Middle Name:
Other - Last Name:NECHIFOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 HERITAGE DR APT 402
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-6218
Mailing Address - Country:US
Mailing Address - Phone:770-881-5052
Mailing Address - Fax:
Practice Address - Street 1:501 HERITAGE DR APT 402
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-6218
Practice Address - Country:US
Practice Address - Phone:770-881-5052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst