Doctor Name: | SUSAN SANFORD |
NPI Number: | 1962754663 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 1026901 |
Business Practice Address: | 362 N Bedford St East Bridgewater, MA - 023331148 |
Business Phone Number: | 5083502350 |
Business Fax Number: | 5083502318 |
Mailing Address: | 175 N Franklin St, HOLBROOK |
State: | MA |
Postal Code: | 023431171 |
Phone Number: | 7817675552 |
Fax Number: | 7819868752 |
NPI Enumeration Date: | 10/05/2012 |
NPI Last Update Date: | 10/05/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 1026901 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |