Provider Demographics
NPI:1760890297
Name:CHANGING DIRECTIONS THERAPY, PLLC
Entity Type:Organization
Organization Name:CHANGING DIRECTIONS THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DD
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-409-3445
Mailing Address - Street 1:420 E CAMINO DEL PINSAPO
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-8786
Mailing Address - Country:US
Mailing Address - Phone:520-981-7847
Mailing Address - Fax:
Practice Address - Street 1:420 E CAMINO DEL PINSAPO
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629-8786
Practice Address - Country:US
Practice Address - Phone:520-981-7847
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty