Provider Demographics
NPI:1114279692
Name:KAISER, SANDRA (BACHELORS IN SOCIAL)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:
Last Name:KAISER
Suffix:
Gender:F
Credentials:BACHELORS IN SOCIAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 GAY RD
Mailing Address - Street 2:609
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789
Mailing Address - Country:US
Mailing Address - Phone:407-480-7192
Mailing Address - Fax:321-233-0222
Practice Address - Street 1:1550 GAY RD
Practice Address - Street 2:609
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2926
Practice Address - Country:US
Practice Address - Phone:407-480-7192
Practice Address - Fax:321-233-0222
Is Sole Proprietor?:No
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health