Individual
SANDRA EISEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2530 COLORADO AVE UNIT 2A, DURANGO, CO 81301-4761
(970) 403-4223
(970) 259-2419
Mailing address
2530 COLORADO AVE UNIT 2A, DURANGO, CO 81301-4761
(970) 403-4223
(970) 259-2419
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3355
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39064300
—
WI
Enumeration date
11/30/2005
Last updated
07/26/2010
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