Individual
IAN SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
603 DOGWOOD DR, GREENVILLE, TX 75402-8107
(469) 677-7680
Mailing address
603 DOGWOOD DR, GREENVILLE, TX 75402-8107
(469) 677-7680
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
79781
TX
101YP2500X
Professional Counselor
6174-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3916173
—
TX
Enumeration date
04/25/2015
Last updated
06/04/2019
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