Provider Demographics
NPI:1295871903
Name:NEWHOUSE, SANDRA R (PHD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:R
Last Name:NEWHOUSE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:NEWHOUSE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1441 SACHEM PL
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-2555
Mailing Address - Country:US
Mailing Address - Phone:434-974-7974
Mailing Address - Fax:434-964-9206
Practice Address - Street 1:1441 SACHEM PL
Practice Address - Street 2:SUITE 4
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-2555
Practice Address - Country:US
Practice Address - Phone:434-974-7974
Practice Address - Fax:434-964-9206
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001863103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical