Provider Demographics
NPI:1063089704
Name:WINANS, SANDRA (PHD, LSSP)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:WINANS
Suffix:
Gender:F
Credentials:PHD, LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11721 SHOREVIEW OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-2305
Mailing Address - Country:US
Mailing Address - Phone:512-808-6037
Mailing Address - Fax:
Practice Address - Street 1:11721 SHOREVIEW OVERLOOK
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-2305
Practice Address - Country:US
Practice Address - Phone:512-808-6037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32283103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist