Provider Demographics
NPI:1871395632
Name:SANDERS, MAKIAH ALEXIS
Entity type:Individual
Prefix:MISS
First Name:MAKIAH
Middle Name:ALEXIS
Last Name:SANDERS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 BLACK LAKE CT
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-8152
Mailing Address - Country:US
Mailing Address - Phone:317-440-5802
Mailing Address - Fax:
Practice Address - Street 1:1305 BLACK LAKE CT
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-8152
Practice Address - Country:US
Practice Address - Phone:317-440-5802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician