Provider Demographics
NPI:1437392677
Name:WISDOM, SAUNDRA LEIGH (LSCSW)
Entity type:Individual
Prefix:MS
First Name:SAUNDRA
Middle Name:LEIGH
Last Name:WISDOM
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:MS
Other - First Name:SAUNDRA
Other - Middle Name:LEIGH
Other - Last Name:DICKERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSCSW
Mailing Address - Street 1:2200 SW GAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66622-0001
Mailing Address - Country:US
Mailing Address - Phone:785-350-3111
Mailing Address - Fax:
Practice Address - Street 1:2200 GAGE BLVD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66622
Practice Address - Country:US
Practice Address - Phone:785-350-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3035104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker