Provider Demographics
NPI:1801291547
Name:SAUNDERS, TAREESA
Entity type:Individual
Prefix:MRS
First Name:TAREESA
Middle Name:
Last Name:SAUNDERS
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 1:5702 EMILY LN
Mailing Address - Street 2:
Mailing Address - City:HAHIRA
Mailing Address - State:GA
Mailing Address - Zip Code:31632-3023
Mailing Address - Country:US
Mailing Address - Phone:229-292-1283
Mailing Address - Fax:
Practice Address - Street 1:1647 NE CAPTAIN BUIE RD
Practice Address - Street 2:
Practice Address - City:PINETTA
Practice Address - State:FL
Practice Address - Zip Code:32350-2799
Practice Address - Country:US
Practice Address - Phone:850-929-3000
Practice Address - Fax:850-929-2210
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist