Provider Demographics
NPI:1861701435
Name:SANDERS, TAMERA MICHELLE
Entity type:Individual
Prefix:
First Name:TAMERA
Middle Name:MICHELLE
Last Name:SANDERS
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 1:2500 THOMAS DR
Mailing Address - Street 2:APT 524
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-2183
Mailing Address - Country:US
Mailing Address - Phone:405-625-8476
Mailing Address - Fax:
Practice Address - Street 1:2500 THOMAS DR
Practice Address - Street 2:APT 524
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-2183
Practice Address - Country:US
Practice Address - Phone:405-625-8476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management