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Individual

CHARLES LEE CHANDLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, EDS

Contact information

Practice address
201 N COURT ST, GLENVILLE, WV 26351-1216
(304) 462-7386
(304) 462-5103
Mailing address
201 N COURT ST, GLENVILLE, WV 26351-1216
(304) 462-7386
(304) 462-5103

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6026
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810001066
WV
Enumeration date
02/08/2008
Last updated
02/08/2008
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