Provider Demographics
NPI:1942348610
Name:PATTERSON, SANDRA LEE (LPC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LEE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4352 EMMETT F LOWRY EXPY
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-2628
Mailing Address - Country:US
Mailing Address - Phone:409-763-2373
Mailing Address - Fax:409-935-0123
Practice Address - Street 1:7510 F.M. 1765
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590
Practice Address - Country:US
Practice Address - Phone:409-935-6083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19139101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84559LOtherBLUE CROSS BLUE SHEILD