Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | KY-00172 | KY |
NPI | 1073632873 |
---|---|
Provider Name | Joan T. Sanford |
First Address | Somerset, KY 42503-2850 |
Second Address | Somerset, KY 42503-2850 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 08/07/2007 |