Healthcare Provider Details

I. General information

NPI: 1801521042
Provider Name (Legal Business Name): CATHERINE SANDERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 07/21/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 N POINT PKWY
ALPHARETTA GA
30022-2409
US

IV. Provider business mailing address

4500 N POINT PKWY
ALPHARETTA GA
30022-2409
US

V. Phone/Fax

Practice location:
  • Phone: 678-762-0370
  • Fax: 678-762-0371
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: