Provider Demographics
NPI:1851736367
Name:CHANDLER, GABRIELLE MARYANN (CER GUIDANCE COUN)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:MARYANN
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:CER GUIDANCE COUN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:KINGSTREE
Mailing Address - State:SC
Mailing Address - Zip Code:29556-2822
Mailing Address - Country:US
Mailing Address - Phone:843-355-1506
Mailing Address - Fax:
Practice Address - Street 1:500 N ACADEMY ST
Practice Address - Street 2:BUILDING K
Practice Address - City:KINGSTREE
Practice Address - State:SC
Practice Address - Zip Code:29556-3408
Practice Address - Country:US
Practice Address - Phone:843-355-5571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC261317101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional