Provider Demographics
NPI:1548840275
Name:ANDREWS, CHANDRA
Entity type:Individual
Prefix:
First Name:CHANDRA
Middle Name:
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 COLUMNS DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-3135
Mailing Address - Country:US
Mailing Address - Phone:678-927-0473
Mailing Address - Fax:
Practice Address - Street 1:302 COLUMNS DR
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-3135
Practice Address - Country:US
Practice Address - Phone:678-927-0473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GABACB596941106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician