Most Relevant Information
Provider Data
| NPI Number: | 1003442286 |
| Provider Name: | BRENDA BURRUSS CHAVIS MD |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | LC11224 |
Most Important Dates
| Enumeration Date: | 03/19/2020 |
| Last Updated: | 01/03/2022 |
Provider Practice Location
6391 ROWANBERRY DR APT 414
ELKRIDGE
MD
210757032
Practice Location Phone/Fax
| Phone: | 4045501684 |
| Fax: | 2403661774 |
Provider Mailing Location
324 MAIN ST UNIT 466
LAUREL
MD
207257520
Provider Mailing Phone/Fax
| Phone: | 4045501684 |
| Fax: | 2403661774 |