| Doctor Name: | MR. CLIFFORD DWAIN SANDERS |
| NPI Number: | 1053658534 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC/LADC |
| License Number: | 798 |
| Business Practice Address: | 214 E Oak Ave Seminole, OK - 748683442 |
| Business Phone Number: | 4053821112 |
| Business Fax Number: | |
| Mailing Address: | 24198 Brangus Rd, TECUMSEH |
| State: | OK |
| Postal Code: | 748737520 |
| Phone Number: | 4055981761 |
| Fax Number: | |
| NPI Enumeration Date: | 01/03/2013 |
| NPI Last Update Date: | 09/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 798 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |