Provider Demographics
NPI:1982856688
Name:SANDERS, MARY E (PHD)
Entity Type:Individual
Prefix:PROF
First Name:MARY
Middle Name:E
Last Name:SANDERS
Suffix:
Gender:F
Credentials:PHD
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Mailing Address - Street 1:1664 N VIRGINIA ST
Mailing Address - Street 2:MAIL STOP 153/REDFIELD BLDG.
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89557-0001
Mailing Address - Country:US
Mailing Address - Phone:775-746-0645
Mailing Address - Fax:775-784-4468
Practice Address - Street 1:1664 N VIRGINIA ST
Practice Address - Street 2:MAIL STOP 153/REDFIELD BLDG.
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89557-0001
Practice Address - Country:US
Practice Address - Phone:775-746-0645
Practice Address - Fax:775-784-4468
Is Sole Proprietor?:No
Enumeration Date:2008-10-14
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV519895224Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist