Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 34006378A | IN |
NPI | 1003011727 |
---|---|
Provider Name | Miss Stephanie Diane Sanchez |
First Address | Muncie, IN 47304-3988 |
Second Address | Indianapolis, IN 46205-1500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2007 |
Last Update Date | 10/08/2017 |