Doctor Name: | SUSAN CHAFFIN |
NPI Number: | 1053727685 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 68601 |
Business Practice Address: | 303 S Highway 78 Suite 202 Wylie, TX - 750983944 |
Business Phone Number: | 4693423468 |
Business Fax Number: | |
Mailing Address: | 303 S Highway 78, Suite 202 WYLIE |
State: | TX |
Postal Code: | 750983944 |
Phone Number: | 4693423468 |
Fax Number: | |
NPI Enumeration Date: | 07/03/2014 |
NPI Last Update Date: | 07/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 68601 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |