Individual
MR. GAVIC JAACOB CHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
810 GREENWOOD AVE, CLARKSVILLE, TN 37040-4068
(931) 206-7257
(931) 260-7332
Mailing address
PO BOX 6, CLARKSVILLE, TN 37041-0006
(931) 206-7356
(931) 260-7332
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
RC00029571
WA
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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