Provider Demographics
NPI:1790887818
Name:SANDERS, BETTY LOUIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:BETTY
Middle Name:LOUIE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:BETT
Other - Middle Name:LOUIE
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:ONE VILLAGE LANE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2677
Mailing Address - Country:US
Mailing Address - Phone:828-274-5388
Mailing Address - Fax:
Practice Address - Street 1:ONE VILLAGE LANE
Practice Address - Street 2:SUITE 2
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2677
Practice Address - Country:US
Practice Address - Phone:828-274-5388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC778103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC778OtherNC LICENSE #