Provider Demographics
NPI:1407073570
Name:SANDEL, ADDISON (PHD)
Entity Type:Individual
Prefix:DR
First Name:ADDISON
Middle Name:
Last Name:SANDEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ADDISON
Other - Middle Name:SANDEL
Other - Last Name:BAXTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1507 BARCLAY DR
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-4903
Mailing Address - Country:US
Mailing Address - Phone:318-352-3573
Mailing Address - Fax:
Practice Address - Street 1:105 BELVIEW RD
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-2902
Practice Address - Country:US
Practice Address - Phone:318-238-6431
Practice Address - Fax:318-238-7070
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA349103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling