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General NPI Number Information
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NPI Number | 1629596614
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Entity Type | Individual
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Provider Name | CHRISTIE JO SANDERS LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/30/2017
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 784 S. CLEARWATER LOOP, SUITE 4022
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City | POST FALLS
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State | ID
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Zip | 83854
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Country | US
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Telephone | 503-389-6320
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Fax |
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Provider Business Mailing Address
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Address Line | 148 BLUE LAKES BLVD N # 120
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City | TWIN FALLS
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State | ID
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Zip | 83301-5235
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | R4875
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT-9488
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T2235
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License Number State | OR
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