Provider Demographics
NPI:1003962390
Name:SESSA, SANDRA ANN (PHD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:ANN
Last Name:SESSA
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 1:90 FLAG POINT RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7534
Mailing Address - Country:US
Mailing Address - Phone:732-341-9101
Mailing Address - Fax:
Practice Address - Street 1:2517 HIGHWAY 35
Practice Address - Street 2:BUILDING J SUITE 103
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1918
Practice Address - Country:US
Practice Address - Phone:732-528-1368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100350300103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist