Provider Demographics
NPI:1861827099
Name:SANDERS, CONSTANCE ELEONORE
Entity Type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:ELEONORE
Last Name:SANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 FIVE FEATHERS ST
Mailing Address - Street 2:UNIT #4
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-3967
Mailing Address - Country:US
Mailing Address - Phone:781-361-1787
Mailing Address - Fax:
Practice Address - Street 1:1860 FIVE FEATHERS ST
Practice Address - Street 2:UNIT #4
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-3967
Practice Address - Country:US
Practice Address - Phone:781-361-1787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner