Provider Demographics
NPI:1053150581
Name:CHANDLER, CATHARINA (BSBA/MINERAL MASTERY)
Entity type:Individual
Prefix:
First Name:CATHARINA
Middle Name:
Last Name:CHANDLER
Suffix:
Gender:F
Credentials:BSBA/MINERAL MASTERY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4988 CHARLTON LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-2704
Mailing Address - Country:US
Mailing Address - Phone:704-330-0937
Mailing Address - Fax:
Practice Address - Street 1:4988 CHARLTON LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-2704
Practice Address - Country:US
Practice Address - Phone:704-330-0937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2216101YP1600X
171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral