MEDICARE: LOUISE SAWYER MA, LEP, NCSP, ABSNP

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
1	103TS0200X	School Psychologist	3667	CA

General Provider Information

NPI Number	:	1689101941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUISE SAWYER MA, LEP, NCSP, ABSNP

Provider Business Mailing Address
First Line	:	PO BOX 283
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93406-0283
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 COTTONWOOD LN
Second Line	:
City	:	SAN LUIS OBISPO
State	:	CA
Zip	:	93405-7811
Country	:	US
Telephone Number	:	512-878-3224
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2017
Last Update Date	:	05/17/2017

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