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General NPI Number Information
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NPI Number | 1255958450
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Entity Type | Individual
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Provider Name | ANDREA SANDLES M.A., LLPC
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Gender | Female
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Dates
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Enumeration Date | 07/03/2020
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Last Update Date | 07/03/2020
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Provider Practice Location Address
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Address Line | 1500 N STEPHENSON HWY STE 240
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City | ROYAL OAK
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State | MI
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Zip | 48067-1584
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Country | US
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Telephone | 248-933-7385
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Fax |
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Provider Business Mailing Address
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Address Line | 1619 CAMDEN ST
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City | FERNDALE
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State | MI
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Zip | 48220-2671
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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 | 221700000X
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Taxonomy Name | Art Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401016919
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License Number State | MI
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