Individual
MS. M FAY SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
888 THACKERAY TRL STE 105, OCONOMOWOC, WI 53066-4342
(262) 542-3255
(262) 567-5451
Mailing address
888 THACKERAY TRL STE 105, OCONOMOWOC, WI 53066-4342
(262) 542-3255
(262) 567-5451
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
392 69600
—
WI
Enumeration date
08/31/2006
Last updated
07/08/2007
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