Provider Demographics
NPI:1528133766
Name:SAUNDERS, ANITA L (PHD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:L
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 SUNNYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-9707
Mailing Address - Country:US
Mailing Address - Phone:317-423-8431
Mailing Address - Fax:
Practice Address - Street 1:6501 SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-9707
Practice Address - Country:US
Practice Address - Phone:317-423-8431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10115267103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100270530Medicaid