Healthcare Provider Details

I. General information

NPI: 1730133000
Provider Name (Legal Business Name): FELICITY L SANDERS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 02/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 ROBESON ST SUITE 200
FAYETTEVILLE NC
28305-5549
US

IV. Provider business mailing address

2411 ROBESON ST SUITE 200
FAYETTEVILLE NC
28305-5549
US

V. Phone/Fax

Practice location:
  • Phone: 910-609-1990
  • Fax: 910-609-1993
Mailing address:
  • Phone: 910-609-1990
  • Fax: 910-609-1993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3886
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: