Chandra Rae Dewberry
Behavior Analyst Pastoral Counselor
74 Burketts Creek Dr
Hattiesburg
, Mississippi 39401-5080
Chandra Rae Dewberry
Behavior Analyst Pastoral Counselor
74 Burketts Creek Dr
Hattiesburg
, Mississippi 39401-5080
(773) 449-0769
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About
Features
Specialties
- Pastoral Counselor
- Behavior Analyst
Languages spoken
- English
Location
First Address
- Chandra Rae Dewberry
- 74 Burketts Creek Dr
- Hattiesburg, MS
- Zip : 39401-5080
- Phone : (773) 449-0769
Second Address
- Chandra Rae Dewberry
- 74 Burketts Creek Dr
- Hattiesburg, MS
- Zip : 39401-5080
- Phone : (773) 449-0769
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 101YP1600X | Pastoral Counselor | MS | |
| Y | 103K00000X | Behavior Analyst | MS |
National Provider Identifier
| NPI | 1265958854 |
|---|---|
| Provider Name | Chandra Rae Dewberry |
| First Address | Hattiesburg, MS 39401-5080 |
| Second Address | Hattiesburg, MS 39401-5080 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/08/2017 |
| Last Update Date | 16/08/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.