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General NPI Number Information
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NPI Number | 1679226682
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Entity Type | Individual
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Provider Name | MIYA MICHELLE SINDLE SCHOOL PSYCHOLOGIST
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Gender | Female
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Dates
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Enumeration Date | 01/31/2022
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Last Update Date | 05/02/2022
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Provider Practice Location Address
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Address Line | 8608 FOBES DR
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City | ANTELOPE
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State | CA
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Zip | 95843-5572
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Country | US
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Telephone | 916-470-0595
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7553
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95621-7553
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Country | US
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Telephone | 916-470-1856
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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