Provider Demographics
NPI:1770860132
Name:CHANDLER, MARGARET B
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:B
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 WAGNON RD
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-9203
Mailing Address - Country:US
Mailing Address - Phone:707-829-0308
Mailing Address - Fax:707-823-6750
Practice Address - Street 1:455 WAGNON RD
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-9203
Practice Address - Country:US
Practice Address - Phone:707-829-0308
Practice Address - Fax:707-823-6750
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-12
Last Update Date:2011-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT22805101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional