Basic Information
| Provider Information | |||||||||
| NPI: | 1750701785 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SANDLER | ||||||||
| FirstName: | MICHELLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9378 BOCA RIVER CIR | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334343960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613395142 | ||||||||
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| Practice Location | |||||||||
| Address1: | 951 BROKEN SOUND PKWY NW STE 350 | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334873531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614655537 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2014 | ||||||||
| LastUpdateDate: | 08/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | N | Technologists, Technicians & Other Technical Service Providers | Technician, Other | 103K00000X | 1-16-24136 | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.