Individual
DR. LIZA SANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
228 W 200 S STE 2E, KAMAS, UT 84036-9010
(801) 360-6955
Mailing address
596 ASH CT, KAMAS, UT 84036-9275
(435) 640-3138
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
435
WY
101YM0800X
Mental Health Counselor
435
WY
101YP2500X
Professional Counselor
1149
WY
101YP2500X
Professional Counselor
Primary
435
WY
101YS0200X
School Counselor
435
WY
103TS0200X
School Psychologist
435
WY
251B00000X
Case Management Agency
435
WY
251C00000X
Developmentally Disabled Services Day Training Agency
435
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128433900
—
WY
Enumeration date
09/22/2009
Last updated
03/17/2018
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