Provider Demographics
NPI:1699055525
Name:SALA, SANDRA DEE (MA, LPC, NCC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:DEE
Last Name:SALA
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:DEE
Other - Last Name:STAMBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1233 LINKS DR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7056
Mailing Address - Country:US
Mailing Address - Phone:248-701-1544
Mailing Address - Fax:
Practice Address - Street 1:12450 CLEVELAND SCHOOL RD
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-8353
Practice Address - Country:US
Practice Address - Phone:919-502-9361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8810101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional