Healthcare Provider Details

I. General information

NPI: 1518179316
Provider Name (Legal Business Name): CAROLYN DENISE SADLER M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 W MORNINGSIDE DR
PHOENIX AZ
85023-2341
US

IV. Provider business mailing address

4708 E PRESERVE WAY
CAVE CREEK AZ
85331-4097
US

V. Phone/Fax

Practice location:
  • Phone: 602-467-6320
  • Fax:
Mailing address:
  • Phone: 480-488-4005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number3421204
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: