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General NPI Number Information
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NPI Number | 1699198390
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Entity Type | Individual
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Provider Name | LAURI SANDERS
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Gender | Female
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Dates
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Enumeration Date | 01/31/2014
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 5860 FULTON DR NW
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City | CANTON
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State | OH
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Zip | 44718
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Country | US
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Telephone | 330-641-3214
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Fax |
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Provider Business Mailing Address
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Address Line | 1155 WILDWOOD DR
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City | WOOSTER
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State | OH
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Zip | 44691-5719
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Country | US
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Telephone | 330-347-8517
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | S-1303220
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License Number State |
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