Provider Demographics
NPI:1194218347
Name:PURCELL, CHANDLER LEE (CGC)
Entity type:Individual
Prefix:
First Name:CHANDLER
Middle Name:LEE
Last Name:PURCELL
Suffix:
Gender:F
Credentials:CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7350 CARDIGAN CIR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-1955
Mailing Address - Country:US
Mailing Address - Phone:734-395-6094
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE ST NE STE 1520
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2247
Practice Address - Country:US
Practice Address - Phone:404-778-3401
Practice Address - Fax:404-686-1652
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-12
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
170300000X
GA159170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS