Provider Demographics
NPI:1376727537
Name:SANCHEZ, AZILDE E (PHD, LPC)
Entity Type:Individual
Prefix:MRS
First Name:AZILDE
Middle Name:E
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 PREAKNESS AVE
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07502-1012
Mailing Address - Country:US
Mailing Address - Phone:973-341-9869
Mailing Address - Fax:
Practice Address - Street 1:555 PREAKNESS AVE
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07502-1012
Practice Address - Country:US
Practice Address - Phone:973-341-9869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00512300103T00000X
NJ37PC00360100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional