Provider Demographics
NPI:1073748950
Name:SASSER, NANCY SASSE (EDD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:SASSE
Last Name:SASSER
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 SHOWALTER RD
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-9199
Mailing Address - Country:US
Mailing Address - Phone:208-301-0918
Mailing Address - Fax:208-882-1490
Practice Address - Street 1:1060 SHOWALTER RD
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-9199
Practice Address - Country:US
Practice Address - Phone:208-301-0918
Practice Address - Fax:208-882-1490
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA686103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling