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General NPI Number Information
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NPI Number | 1013072479
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Entity Type | Individual
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Provider Name | CHERYL LYNN SANDERS MC, LPC
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Gender | Female
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1232 E BROADWAY RD SUITE #120
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City | TEMPE
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State | AZ
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Zip | 85282-1511
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Country | US
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Telephone | 480-784-1514
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Fax |
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Provider Business Mailing Address
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Address Line | 1718 S LONGMORE UNIT 40
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City | MESA
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State | AZ
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Zip | 85202-5768
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Country | US
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Telephone | 480-775-6444
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-11167
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License Number State | AZ
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