Basic Information
| Provider Information | |||||||||
| NPI: | 1043307820 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DONALDSON | ||||||||
| FirstName: | SANDRA | ||||||||
| MiddleName: | |||||||||
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| Credential: | LMSW, CAADC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1320 N MICHIGAN AVE STE 5 | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486024751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894019015 | ||||||||
| FaxNumber: | 9894019018 | ||||||||
| Practice Location | |||||||||
| Address1: | 1320 N MICHIGAN AVE STE 5 | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486024751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894019015 | ||||||||
| FaxNumber: | 9894019018 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2006 | ||||||||
| LastUpdateDate: | 01/25/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 6801079011 | MI | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 1041C0700X | 6801079011 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.