Provider Demographics
NPI:1780918755
Name:LISA M. SANDLER, PSY.D, P.A.
Entity type:Organization
Organization Name:LISA M. SANDLER, PSY.D, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:SANDLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:561-654-4645
Mailing Address - Street 1:6809 TOWN HARBOUR BLVD
Mailing Address - Street 2:1911
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5062
Mailing Address - Country:US
Mailing Address - Phone:561-654-4645
Mailing Address - Fax:
Practice Address - Street 1:6809 TOWN HARBOUR BLVD
Practice Address - Street 2:1911
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5062
Practice Address - Country:US
Practice Address - Phone:561-654-4645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7407103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty