Individual
CHANDA LICHTSINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2626 SAINT JOE CENTER RD, FORT WAYNE, IN 46825-5042
(260) 497-0328
(260) 497-0904
Mailing address
3703 ARLINGTON AVE, FORT WAYNE, IN 46807-2301
(260) 456-4988
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22003366A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200324980
—
IN
01
—
200621390
FIRST STEPS
IN
Enumeration date
02/16/2007
Last updated
01/25/2023
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