Individual
CHANDLER BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1450 54TH ST STE C, COLUMBUS, GA 31904-4494
(706) 221-1208
(904) 538-0713
Mailing address
10175 FORTUNE PKWY UNIT 903, JACKSONVILLE, FL 32256-6755
(904) 538-0713
(904) 538-0714
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-38576
AL
Other
Enumeration date
06/19/2019
Last updated
02/12/2020
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