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NPI Code Detail

MEDICARE: JADA SANDERS

MEDICARE: JADA SANDERS
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
1106S00000XBehavior TechnicianLA

General Provider Information

NPI Number : 1417500596
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADA SANDERS
Provider Business Mailing Address
First Line : 4201 N I 10 SERVICE RD W
Second Line :
City : METAIRIE
State : LA
Zip : 70006-6713
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9063 SIEGEN LN STE A
Second Line :
City : BATON ROUGE
State : LA
Zip : 70810-2051
Country : US
Telephone Number : 225-294-1600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2019
Last Update Date : 07/18/2019

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Directions to “ JADA SANDERS ” Practice Location

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