Provider Demographics
NPI:1851547335
Name:SANDERS, ALEXIS (PHD)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:SANDERS
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 1:1516 S LANGLEY DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6149
Mailing Address - Country:US
Mailing Address - Phone:843-621-0263
Mailing Address - Fax:843-536-8522
Practice Address - Street 1:1516 S LANGLEY DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6149
Practice Address - Country:US
Practice Address - Phone:843-621-0263
Practice Address - Fax:843-536-8522
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1246103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical