Provider Demographics
NPI:1295822641
Name:SANEDA, DEBORAH LYNNE (PHD PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LYNNE
Last Name:SANEDA
Suffix:
Gender:F
Credentials:PHD PSYCHOLOGIST
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Mailing Address - Street 1:1035 W MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-2106
Mailing Address - Country:US
Mailing Address - Phone:276-228-6900
Mailing Address - Fax:276-228-6910
Practice Address - Street 1:1035 W MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-2106
Practice Address - Country:US
Practice Address - Phone:276-228-6900
Practice Address - Fax:276-228-6910
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0810003706103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist