Stader, Sandra R

Stader, Sandra R is an individual health care provider with primary practice located at 1800 Colonial Dr , Columbia SC 29203-6827. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Stader, Sandra R can be contacted via phone (803) 898-8405.

Contact Information

Primary practice address
1800 Colonial Dr Columbia SC 29203-6827
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 621 South Carolina

Profile Details

NPI number 1659423721
LBN Legal business name Stader, Sandra R
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2007
Last updated Mar 10th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659423721 NPPES
South Carolina MEDICAID PS0302

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