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General NPI Number Information
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NPI Number | 1700071719
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Entity Type | Organization
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Legal Business Name | DEBORAH L SANEDA PHD
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | 430 E MAIN ST SUITE A
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City | WYTHEVILLE
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State | VA
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Zip | 24382-2351
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Country | US
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Telephone | 276-228-2998
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Fax | 276-228-2905
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Provider Business Mailing Address
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Address Line | 430 E MAIN ST SUITE A
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City | WYTHEVILLE
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State | VA
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Zip | 24382-2351
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Country | US
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Telephone | 276-228-2998
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Fax | 276-228-2905
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST/OWNE
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Name | DR. DEBORAH LYNNE SANEDA
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Credential | PH,D.
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Telephone | 276-228-2998
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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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Taxonomy #2
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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