| NPI | 1578018263 |
|---|---|
| Professional Name | TINA SANFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17676-130) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 4810-226) |
| Enumeration Date | 2016-08-23 |
| Last Update Date | 2023-09-12 |