| Organization Name: | SANDRA L. PARENT, PH.D., LP, PLLC |
| NPI Number: | 1194097626 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SANDRA L. PARENT (PSYCHOLOGIST/SOLE PROPRIETOR) |
| Mailing Address: | 15460 Daniel Ct Allen Park |
| State: | MI US |
| Postal Code: | 481013306 |
| Phone Number: | 3133046352 |
| Fax Number: | 3132219998 |
| NPI Enumeration Date: | 01/30/2012 |
| NPI Last Update Date: | 01/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 6301014705 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |