Basic Information
| Provider Information | |||||||||
| NPI: | 1497906440 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANDERS | ||||||||
| FirstName: | SHARON | ||||||||
| MiddleName: | G | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2221 | ||||||||
| Address2: | |||||||||
| City: | ROCKPORT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 783812221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3617270143 | ||||||||
| FaxNumber: | 3617272036 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 N MAGNOLIA ST | ||||||||
| Address2: | |||||||||
| City: | ROCKPORT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 783822748 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3617270143 | ||||||||
| FaxNumber: | 3617272036 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2008 | ||||||||
| LastUpdateDate: | 10/08/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 61651 | TX | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.