Provider Demographics
NPI:1164430864
Name:DEBORAH L SANO PHD LLC
Entity Type:Organization
Organization Name:DEBORAH L SANO PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:SANO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:330-506-9610
Mailing Address - Street 1:PO BOX 114
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-0114
Mailing Address - Country:US
Mailing Address - Phone:330-506-9610
Mailing Address - Fax:
Practice Address - Street 1:7010 SOUTH AVE STE 5
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-3603
Practice Address - Country:US
Practice Address - Phone:330-953-0373
Practice Address - Fax:330-953-1373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301011855103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty