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General NPI Number Information
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NPI Number | 1346768298
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Entity Type | Organization
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Legal Business Name | JENNIFER L. SANDERS LPP LLC
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Dates
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Enumeration Date | 08/30/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 7980 NEW LA GRANGE RD STE 7
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City | LOUISVILLE
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State | KY
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Zip | 40222-4767
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Country | US
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Telephone | 502-904-3509
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Fax |
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Provider Business Mailing Address
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Address Line | 7980 NEW LA GRANGE RD STE 7
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City | LOUISVILLE
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State | KY
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Zip | 40222-4767
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Country | US
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Telephone | 502-904-3509
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER SANDERS
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Credential | LPP
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Telephone | 502-904-3509
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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 |
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License Number State |
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