Provider Demographics
NPI:1033241450
Name:DUEMMLER, SANDRA LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LYNN
Last Name:DUEMMLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 IVY ROCK RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-8148
Mailing Address - Country:US
Mailing Address - Phone:302-983-7971
Mailing Address - Fax:
Practice Address - Street 1:1 IVY ROCK RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-8148
Practice Address - Country:US
Practice Address - Phone:302-983-7971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0000600103TC0700X
PAPS019473103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
491821Medicare ID - Type Unspecified