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NPI Code Detail

MEDICARE: KRISTINA ANNE SANDERSON

MEDICARE: KRISTINA ANNE 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
1106S00000XBehavior Technician1417568304CO

General Provider Information

NPI Number : 1417568304
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA ANNE SANDERSON
Provider Business Mailing Address
First Line : 5850 GRANITE PKWY STE 600
Second Line :
City : PLANO
State : TX
Zip : 75024-6753
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 1044 W DRAKE RD # 100
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-3079
Country : US
Telephone Number : 970-305-8642
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2020
Last Update Date : 02/09/2023

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Directions to “ KRISTINA ANNE SANDERSON ” Practice Location

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