| Doctor Name: | WANDA SANDERS |
| NPI Number: | 1497162374 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | LPC008194 |
| Business Practice Address: | 114 E Hall St Thomson, GA - 308242726 |
| Business Phone Number: | 7065958548 |
| Business Fax Number: | |
| Mailing Address: | 114 E Hall St, THOMSON |
| State: | GA |
| Postal Code: | 308242726 |
| Phone Number: | 7065958548 |
| Fax Number: | |
| NPI Enumeration Date: | 07/12/2014 |
| NPI Last Update Date: | 12/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LPC008194 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |