Individual
DERRELL J CHANDLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LISW-CP
Contact information
Practice address
475 SUMMIT DR, MINOT, ND 58705-5010
(843) 909-1677
Mailing address
1410 30TH AVE NW APT 5113, MINOT, ND 58703-5085
(843) 909-1677
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8631
SC
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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