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Organization

SANDERSON PSYCHOLOGICAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BROOKE NICOLE SANDERSON PSY.D. (PRESIDENT)
(412) 370-4848
Entity
Organization

Contact information

Practice address
95 ENTERPRISE ST, SUITE 104, ELIZABETH, PA 15037-2070
(412) 370-4848
(412) 754-2006
Mailing address
95 ENTERPRISE ST, SUITE 104, ELIZABETH, PA 15037-2070
(412) 370-4848
(412) 754-2006

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
PC006524
PA
251S00000X
Community/Behavioral Health Agency
Primary
PS018190
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1871842591
NPI INDIVIDUAL
PA
Enumeration date
01/31/2017
Last updated
05/11/2017
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