Individual
JOHNELLE CHAMBERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4045 S SHELBY LN, DOUGLASVILLE, GA 30135-4141
(678) 458-5621
Mailing address
4045 S SHELBY LN, DOUGLASVILLE, GA 30135-4141
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0555561897
DRIVERS LICENSE
GA
05
—
85-2447916
—
GA
Enumeration date
08/20/2020
Last updated
07/21/2022
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