Provider Demographics
NPI:1760762306
Name:PALMER, SANDRA J (LMHC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:J
Last Name:PALMER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8165 FRESH CRK
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-5508
Mailing Address - Country:US
Mailing Address - Phone:561-315-7633
Mailing Address - Fax:
Practice Address - Street 1:8165 FRESH CRK
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-5508
Practice Address - Country:US
Practice Address - Phone:561-315-7633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMHC7305101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health