Individual
MAITRI SURINDER PRAKASH CHAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
655 1ST ST, MACON, GA 31201-2852
(478) 301-5930
(478) 301-5932
Mailing address
PO BOX 4947, MACON, GA 31208-4947
(478) 301-2397
(478) 301-2128
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001155
GA
Other
Enumeration date
10/13/2010
Last updated
10/13/2010
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