Individual
ANDREA SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6202 S LEWIS AVE STE H, TULSA, OK 74136-1064
(918) 949-4086
Mailing address
1234 N FRANKFORT AVE, TULSA, OK 74106-4846
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200287120A
—
OK
Enumeration date
09/10/2012
Last updated
09/10/2012
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