Individual
GLENDA SHANE CHANDLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
285 HOLMES PITTMAN RD, FOXWORTH, MS 39483-3166
(601) 736-3111
(601) 444-5036
Mailing address
4244 HIGHWAY 84 E, LAUREL, MS 39443-7381
(601) 580-2341
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
108839
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S3247
MISSISSIPPI DEPT OF HEALTH
MS
Enumeration date
05/21/2013
Last updated
05/21/2013
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