Provider Demographics
NPI:1790018620
Name:SANDERS, AMY (PSYD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 JESSE HILL JR DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3032
Mailing Address - Country:US
Mailing Address - Phone:404-778-1450
Mailing Address - Fax:404-778-1467
Practice Address - Street 1:35 JESSE HILL JR DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3032
Practice Address - Country:US
Practice Address - Phone:404-778-1450
Practice Address - Fax:404-778-1467
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003501103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical