Individual
SANDRA S PHALEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
348 GRANVILLE ST STE B, GAHANNA, OH 43230-2926
(614) 475-7462
(614) 475-4758
Mailing address
181 GRANVILLE STREET, SUITE G, GAHANNA, OH 43230-2993
(614) 475-7462
(614) 475-4758
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3825
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0648919
—
OH
Enumeration date
03/23/2006
Last updated
04/03/2020
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