Doctor Name: | CHANDRA DIANA NOVAK |
NPI Number: | 1023331089 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LLPC |
License Number: | 6401011672 |
Business Practice Address: | 8623 N Wayne Rd Westland, MI - 481851137 |
Business Phone Number: | 7344271144 |
Business Fax Number: | 7347420608 |
Mailing Address: | 8623 N Wayne Rd, WESTLAND |
State: | MI |
Postal Code: | 481851137 |
Phone Number: | 7344271144 |
Fax Number: | 7347420608 |
NPI Enumeration Date: | 03/04/2010 |
NPI Last Update Date: | 03/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6401011672 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |