Individual
SANDRA C FANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
5 W 19TH ST RM 3R, NEW YORK, NY 10011-4238
(786) 244-7711
Mailing address
5 W 19TH ST RM 3R, NEW YORK, NY 10011-4238
(786) 244-7711
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
0810007917
VA
Other
Enumeration date
12/27/2023
Last updated
08/14/2024
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