Provider Demographics
NPI:1417192014
Name:SANDERSON, EMILY
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:SANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 2ND AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-4379
Mailing Address - Country:US
Mailing Address - Phone:334-741-4041
Mailing Address - Fax:
Practice Address - Street 1:403 2ND AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-4379
Practice Address - Country:US
Practice Address - Phone:334-741-4041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1945235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist