Provider Demographics
NPI:1659148518
Name:SANDERS, DENISE (CSW)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:976 E HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:MILLCREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84106-2117
Mailing Address - Country:US
Mailing Address - Phone:801-792-5477
Mailing Address - Fax:
Practice Address - Street 1:1334 E INTEGRA CT
Practice Address - Street 2:
Practice Address - City:MILLCREEK
Practice Address - State:UT
Practice Address - Zip Code:84106-4412
Practice Address - Country:US
Practice Address - Phone:801-449-0426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12672453-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical