Provider Demographics
NPI:1356093157
Name:DURHAM, SANDRA (MASTERS MFT)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:DURHAM
Suffix:
Gender:F
Credentials:MASTERS MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4636 LEBANON PIKE
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1316
Mailing Address - Country:US
Mailing Address - Phone:615-606-3847
Mailing Address - Fax:
Practice Address - Street 1:805 WOODLAND ST UNIT 340
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37206-3765
Practice Address - Country:US
Practice Address - Phone:615-477-1475
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-23
Last Update Date:2022-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist