Individual
JENNIFER SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPP
Contact information
Practice address
7980 NEW LA GRANGE RD STE 7, LOUISVILLE, KY 40222-4767
(502) 904-3509
Mailing address
7980 NEW LA GRANGE RD STE 7, LOUISVILLE, KY 40222-4767
(502) 904-3509
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
KY
103TC0700X
Clinical Psychologist
Primary
172730
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30605018
—
KY
Enumeration date
02/19/2007
Last updated
07/21/2022
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