Individual
MINOR CHAMBLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
1543 KINGSLEY AVE, SUITE 18A, ORANGE PARK, FL 32073-4535
(904) 269-3324
(904) 264-2302
Mailing address
1543 KINGSLEY AVE, ORANGE PARK, FL 32073-4535
(904) 269-3324
(904) 264-2302
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY 3646
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73837
BCBS
FL
Enumeration date
01/04/2007
Last updated
12/17/2019
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