Individual
MRS. TRIVA WATTS SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRC, CCSCC
Contact information
Practice address
718 BOWMAR AVE, VICKSBURG, MS 39180-4603
(850) 363-0012
Mailing address
1651 OAK RIDGE RD, VICKSBURG, MS 39183-9310
(817) 800-0612
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YP1600X
Pastoral Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
225100000X
Physical Therapist
—
—
225700000X
Massage Therapist
—
—
225C00000X
Rehabilitation Counselor
—
—
225X00000X
Occupational Therapist
—
—
251J00000X
Nursing Care Agency
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
02/06/2026
Last updated
02/06/2026
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