Provider Demographics
NPI:1952660375
Name:COHRAN, CHANDRA LEATRICE (MS)
Entity Type:Individual
Prefix:
First Name:CHANDRA
Middle Name:LEATRICE
Last Name:COHRAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6161 W CHARLESTON BLVD
Mailing Address - Street 2:BLDG 2
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-1126
Mailing Address - Country:US
Mailing Address - Phone:702-486-9651
Mailing Address - Fax:
Practice Address - Street 1:6161 W CHARLESTON BLVD
Practice Address - Street 2:BLDG 2
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1126
Practice Address - Country:US
Practice Address - Phone:702-486-9651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health