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Individual

MRS. CHARLOTTE ELAINE CHAPMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS.CCC.SLP

Contact information

Practice address
620 N ALLEGHANEY AVE, ODESSA, TX 79761-4408
(432) 332-8244
(432) 580-7428
Mailing address
4061 CANDY LN, ODESSA, TX 79762-7127
(432) 550-0591

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
100356
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100356
STATE LICENSE NUMBER
TX
01
129204
SUPERIOR PROVIDER NUMBER
TX
01
8T0118
BCBS PROVIDER NUMBER
TX
Enumeration date
03/12/2007
Last updated
07/08/2007
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