Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 104100000X | Social Worker | FL |
NPI | 1003305996 |
---|---|
Provider Name | Laurie Ann Sanders |
First Address | Wesley Chapel, FL 33545-1660 |
Second Address | Wesley Chapel, FL 33545-1660 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2018 |
Last Update Date | 04/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101066600 | (05) | FL |