Provider Demographics
NPI:1114682267
Name:SANDHILL PSYCHOLOGY
Entity Type:Organization
Organization Name:SANDHILL PSYCHOLOGY
Other - Org Name:SANDHILL PSYCHOLOGY, PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:SOLE MEMBER/CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:517-580-5727
Mailing Address - Street 1:455 E EISENHOWER PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-3324
Mailing Address - Country:US
Mailing Address - Phone:517-580-5727
Mailing Address - Fax:517-709-7731
Practice Address - Street 1:455 E EISENHOWER PKWY STE 300
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-3324
Practice Address - Country:US
Practice Address - Phone:517-580-5727
Practice Address - Fax:517-709-7731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty