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NPI Code Detail

MEDICARE: MARLA SANDERSON

MEDICARE: MARLA SANDERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist77651CA
2106H00000XMarriage & Family TherapistLMFT103814CA
3106H00000XMarriage & Family TherapistMFT.0002340CO
4106H00000XMarriage & Family TherapistLMFT203476TX

General Provider Information

NPI Number : 1306007752
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLA SANDERSON
Provider Business Mailing Address
First Line : 1401 BULLHILL CV
Second Line :
City : CEDAR PARK
State : TX
Zip : 78613-7174
Country : US
Telephone Number : 510-703-6409
Fax Number :
Provider Business Practice Location Address
First Line : 9501 N CAPITAL OF TEXAS HWY STE 201
Second Line :
City : AUSTIN
State : TX
Zip : 78759-7250
Country : US
Telephone Number : 512-578-8070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2008
Last Update Date : 05/31/2023

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