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Individual
MR. CHARLES SANDERS
Active
Individual
MR. CHARLES SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS BCBA
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
1-19-38715
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
Other
Enumeration date
03/13/2015
Last updated
12/26/2019
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