Provider Demographics
NPI:1447066774
Name:SANDERS, AUSTEN RIVER
Entity type:Individual
Prefix:
First Name:AUSTEN
Middle Name:RIVER
Last Name:SANDERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:AUSTEN
Other - Middle Name:RIVER
Other - Last Name:HINDENACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1318 S VINEYARD APT 73
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-8988
Mailing Address - Country:US
Mailing Address - Phone:480-410-2630
Mailing Address - Fax:
Practice Address - Street 1:1347 N ALMA SCHOOL RD STE 220
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5932
Practice Address - Country:US
Practice Address - Phone:888-540-2948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician