Provider Demographics
NPI:1275374324
Name:SANDERS, CHANTEL ALANI
Entity type:Individual
Prefix:
First Name:CHANTEL
Middle Name:ALANI
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 1:1050 S LONGMORE APT 309
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4254
Mailing Address - Country:US
Mailing Address - Phone:480-415-5041
Mailing Address - Fax:
Practice Address - Street 1:1050 S LONGMORE APT 309
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4254
Practice Address - Country:US
Practice Address - Phone:480-415-5041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA152212355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant