Provider Demographics
NPI:1760231625
Name:DONNY, CHANDLER (MED)
Entity type:Individual
Prefix:
First Name:CHANDLER
Middle Name:
Last Name:DONNY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 S BROAD ST STE 1835
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19109-1008
Mailing Address - Country:US
Mailing Address - Phone:267-495-4951
Mailing Address - Fax:
Practice Address - Street 1:123 S BROAD ST STE 1835
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19109-1008
Practice Address - Country:US
Practice Address - Phone:267-495-4951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health