Provider Demographics
NPI:1265496293
Name:SAUNDERS, NANCY L (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:L
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:BARTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:501 N PROVIDENCE RD
Mailing Address - Street 2:#103
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-2557
Mailing Address - Country:US
Mailing Address - Phone:610-543-3418
Mailing Address - Fax:
Practice Address - Street 1:501 N PROVIDENCE RD
Practice Address - Street 2:#103
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2557
Practice Address - Country:US
Practice Address - Phone:610-543-3418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004964L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
509126Medicare UPIN