Provider Demographics
NPI:1295575504
Name:SANDERS, NICOLLETTE
Entity type:Individual
Prefix:
First Name:NICOLLETTE
Middle Name:
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 1:12901 BIG SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANA
Mailing Address - State:TN
Mailing Address - Zip Code:37037-5935
Mailing Address - Country:US
Mailing Address - Phone:931-241-0748
Mailing Address - Fax:
Practice Address - Street 1:112 S MAPLE ST STE C-3
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-3530
Practice Address - Country:US
Practice Address - Phone:615-212-9270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health