Healthcare Provider Details

I. General information

NPI: 1316453533
Provider Name (Legal Business Name): DANE SAUNDERS PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2017
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 LEXINGTON AVE
EAST LANSDOWNE PA
19050-2516
US

IV. Provider business mailing address

240 E MONTGOMERY AVE UNIT 12
ARDMORE PA
19003-3322
US

V. Phone/Fax

Practice location:
  • Phone: 484-469-0781
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS018955
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: