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General NPI Number Information
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NPI Number | 1487432365
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Entity Type | Individual
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Provider Name | SARA FENDER MA, LPC
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Gender | Female
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Dates
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Enumeration Date | 09/20/2023
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 26331 S HARMS RD
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City | CANBY
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State | OR
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Zip | 97013-8300
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Country | US
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Telephone | 971-217-8790
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 316
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City | CANBY
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State | OR
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Zip | 97013-0316
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Country | US
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Telephone | 971-217-8790
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C7553
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License Number State | OR
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