Healthcare Provider Details

I. General information

NPI: 1033241450
Provider Name (Legal Business Name): SANDRA LYNN DUEMMLER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 02/07/2024
Certification Date: 01/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 IVY ROCK RD
WEST CHESTER PA
19382-8148
US

IV. Provider business mailing address

1 IVY ROCK RD
WEST CHESTER PA
19382-8148
US

V. Phone/Fax

Practice location:
  • Phone: 302-983-7971
  • Fax:
Mailing address:
  • Phone: 302-983-7971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0000600
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS019473
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: