Doctor Name: | CANDICE CHAPMAN |
NPI Number: | 1073970562 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 115 W Broadway St Suite 401 Ardmore, OK - 734016205 |
Business Phone Number: | 5802265209 |
Business Fax Number: | 5802265219 |
Mailing Address: | Po Box 1710, KINGSTON |
State: | OK |
Postal Code: | 734391710 |
Phone Number: | 5807459610 |
Fax Number: | 5807459891 |
NPI Enumeration Date: | 01/28/2016 |
NPI Last Update Date: | 01/28/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |