Individual
DEMIA CHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MENTAL HEALTH TECH
Contact information
Practice address
4747 W 24TH AVE, GARY, IN 46406-2821
(219) 240-8615
(219) 977-1197
Mailing address
4747 W 24TH AVE, GARY, IN 46406-2821
(219) 240-8615
(219) 977-1197
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA0806442
IN
Other
Enumeration date
10/24/2015
Last updated
10/24/2015
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