Individual
CHANDRA FAISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
548 SE JACKSON ST, ROSEBURG, OR 97470-4983
(541) 440-3532
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 440-3532
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/16/2023
Last updated
04/10/2025
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