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Individual

MICHAEL SANDERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
100 FOREST CT, KNOXVILLE, TN 37919-5079
(865) 673-8888
Mailing address
5417 HOLSTON HILLS RD, KNOXVILLE, TN 37914-5131

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
P1043
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P1043
NONE
TN
Enumeration date
03/15/2019
Last updated
06/11/2019
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