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Individual

PRAMA CHAKRAVARTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, HSPP

Contact information

Practice address
780 SWIFT BLVD, RICHLAND, WA 99352
(509) 942-2028
(509) 942-3218
Mailing address
560 GAGE BLVD, SUITE 203, RICHLAND, WA 99352-8650
(509) 942-3627
(509) 942-2268

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
20042688A
IN
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PY60465923
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PY60465923
WA
Enumeration date
12/06/2011
Last updated
02/13/2015
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