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General NPI Number Information
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NPI Number | 1194057158
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Entity Type | Individual
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Provider Name | KRISTEN SANDERSON
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Gender | Female
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Dates
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Enumeration Date | 02/02/2010
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Last Update Date | 02/02/2010
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Provider Practice Location Address
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Address Line | 616 ARMORY ST
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City | GREENSBORO
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State | AL
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Zip | 36744-2110
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Country | US
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Telephone | 334-624-3361
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Fax |
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Provider Business Mailing Address
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Address Line | 64 DANBURY RD
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City | WILTON
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State | CT
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Zip | 06897-4429
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Country | US
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Telephone |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 3114
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License Number State | AL
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