Healthcare Provider Details

I. General information

NPI: 1447785175
Provider Name (Legal Business Name): SANDRA SKLADANY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SANDRA FROHNAPPLE

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 PEARL ST STE 206
EUGENE OR
97401-3564
US

IV. Provider business mailing address

1245 PEARL ST STE 206
EUGENE OR
97401-3564
US

V. Phone/Fax

Practice location:
  • Phone: 458-201-9557
  • Fax:
Mailing address:
  • Phone: 458-201-9557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC6084
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: