Provider Demographics
NPI:1770235079
Name:EVARRS, SANDRA BRUNNER (PHD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:BRUNNER
Last Name:EVARRS
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 1:309 LANTERN RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8856
Mailing Address - Country:US
Mailing Address - Phone:919-720-1744
Mailing Address - Fax:
Practice Address - Street 1:309 LANTERN RIDGE LN
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-8856
Practice Address - Country:US
Practice Address - Phone:919-720-1744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5155103TS0200X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty