Provider Demographics
NPI:1831347228
Name:LINDEMANN, SANDRA BRYANT
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:BRYANT
Last Name:LINDEMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:BOTHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:461 S BRYANT AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-4775
Mailing Address - Country:US
Mailing Address - Phone:520-232-7700
Mailing Address - Fax:
Practice Address - Street 1:461 S BRYANT AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-4775
Practice Address - Country:US
Practice Address - Phone:520-232-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool