Provider Demographics
NPI:1720015548
Name:ISAACSON, SANDI L (PHD)
Entity Type:Individual
Prefix:DR
First Name:SANDI
Middle Name:L
Last Name:ISAACSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9212 W 103RD ST
Mailing Address - Street 2:APT. B.
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5501
Mailing Address - Country:US
Mailing Address - Phone:913-438-2100
Mailing Address - Fax:
Practice Address - Street 1:10801 W 87TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66214-1657
Practice Address - Country:US
Practice Address - Phone:913-438-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS981103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist