| Organization Name: | CANDLER PSYCHOLOGICAL SERVICES |
| NPI Number: | 1710039839 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SUSAN DAUGHTRY FERRELL (LICENSED PSYCHOLOGIST) |
| Mailing Address: | 66 N Rountree St Metter |
| State: | GA US |
| Postal Code: | 304394019 |
| Phone Number: | 9126856259 |
| Fax Number: | 9126859871 |
| NPI Enumeration Date: | 01/17/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 001780 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |