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General NPI Number Information
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NPI Number | 1326175001
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Entity Type | Individual
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Provider Name | LONNIE PETE SANSBURY PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 09/21/2010
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Provider Practice Location Address
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Address Line | 1 ZILLICOA ST
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City | ASHEVILLE
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State | NC
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Zip | 28801-1038
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Country | US
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Telephone | 828-252-5350
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Fax | 828-252-5350
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Provider Business Mailing Address
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Address Line | PO BOX 1887
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City | ASHEVILLE
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State | NC
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Zip | 28802-1887
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Country | US
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Telephone | 828-252-5350
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Fax | 828-252-5305
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1759
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License Number State | NC
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