Most Relevant Information
Provider Data
| NPI Number: | 1003526500 |
| Provider Name: | ELLERY CHANDLER |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/25/2022 |
| Last Updated: | 11/25/2022 |
Provider Practice Location
1140 W 1130 S
BUILDING B
OREM
UT
840588405
Practice Location Phone/Fax
| Phone: | 8019354171 |
| Fax: |
Provider Mailing Location
16255 VENTURA BLVD STE 830
ENCINO
CA
914362317
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |