| NPI | 1255397022 |
|---|---|
| Former Name | SANDRA SANDERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: HI 86) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: AZ 10126) |
| 101YP2500X Counselor Professional (Licence: CO 388) | |
| 101YP2500X Counselor Professional (Licence: AZ 0900) | |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2007-07-08 |