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General NPI Number Information
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NPI Number | 1801947122
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Entity Type | Individual
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Provider Name | SANDRA GIDDENS LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 226 E MAIN ST STE C
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City | SENATOBIA
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State | MS
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Zip | 38668-2133
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Country | US
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Telephone | 662-503-7384
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Fax | 662-214-6190
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Provider Business Mailing Address
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Address Line | 2312 RADER CREEK RD
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City | SARAH
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State | MS
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Zip | 38665-3137
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Country | US
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Telephone | 662-503-7384
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Fax | 662-214-6190
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C8823
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2367-C
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License Number State | AR
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