Most Relevant Information
Provider Data
| NPI Number: | 1003432303 |
| Provider Name: | LISA MARIE SANDERS CDCA 165881 |
| Entity Type: | Individual |
| Taxonomy Code: | 101YS0200X |
| Specialty: | Counselor |
| License Number: | 165881 |
Most Important Dates
| Enumeration Date: | 06/23/2020 |
| Last Updated: | 06/23/2020 |
Provider Practice Location
7350 MONTGOMERY RD STE 516
CINCINNATI
OH
452367500
Practice Location Phone/Fax
| Phone: | 5132397361 |
| Fax: |
Provider Mailing Location
PO BOX 36516
CINCINNATI
OH
452360516
Provider Mailing Phone/Fax
| Phone: | 5132397361 |
| Fax: |