Basic Information
| Provider Information | |||||||||
| NPI: | 1629540257 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SANFORD | ||||||||
| FirstName: | RHONDA | ||||||||
| MiddleName: | JEAN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WATSON | ||||||||
| OtherFirstName: | RHONDA | ||||||||
| OtherMiddleName: | JEAN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | LCSW | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | COATESVILLE VAMC, ATTN: RHONDA SANFORD, LCSW, | ||||||||
| Address2: | 1400 BLACKHORSE HILL RD, BLDG 57, RM 227 | ||||||||
| City: | COATESVILLLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103847711 | ||||||||
| FaxNumber: | 6103830264 | ||||||||
| Practice Location | |||||||||
| Address1: | COATESVILLE VAMC, ATTN: RHONDA SANFORD, LCSW, | ||||||||
| Address2: | 1400 BLACKHORSE HILL RD, BLDG 57, RM 227 | ||||||||
| City: | COATESVILLLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103847711 | ||||||||
| FaxNumber: | 6103830264 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2018 | ||||||||
| LastUpdateDate: | 12/20/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CW016686 | PA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.