Provider Demographics
NPI:1689043481
Name:FUSON-CHANDLER, FLORIZA (LMSW)
Entity Type:Individual
Prefix:
First Name:FLORIZA
Middle Name:
Last Name:FUSON-CHANDLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7760 ALABAMA ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79904-3136
Mailing Address - Country:US
Mailing Address - Phone:915-757-7999
Mailing Address - Fax:
Practice Address - Street 1:7760 ALABAMA ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79904-3136
Practice Address - Country:US
Practice Address - Phone:915-757-7999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX58031104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker