Provider Demographics
NPI:1154162287
Name:CHANDLER, LYBERTI RAEAL-MARIE
Entity type:Individual
Prefix:MS
First Name:LYBERTI
Middle Name:RAEAL-MARIE
Last Name:CHANDLER
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 1:1880 LITTLE WATER DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-6241
Mailing Address - Country:US
Mailing Address - Phone:614-519-8974
Mailing Address - Fax:
Practice Address - Street 1:1880 LITTLE WATER DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-6241
Practice Address - Country:US
Practice Address - Phone:614-519-8974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider