| NPI | 1730547811 |
|---|---|
| Former Name | MYRA ANN SANDFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801104031) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-02-04 |
| Last Update Date | 2022-10-06 |