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Individual

DR. MARY LOUISE SANDERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.,

Contact information

Practice address
9102 N MERIDIAN ST STE 400, INDIANAPOLIS, IN 46260
(317) 574-1785
(317) 574-1786
Mailing address
9102 N MERIDIAN ST STE 400, INDIANAPOLIS, IN 46260-1809
(317) 574-1785
(317) 574-1786

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20040682A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1073067526
IN
05
1326068495
IN
05
1487700639
IN
05
1619184678
IN
05
1841498854
IN
Enumeration date
07/20/2006
Last updated
06/05/2018
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