Provider Demographics
NPI:1033606074
Name:TUBO, SANDRA K (M ED, MS,)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:K
Last Name:TUBO
Suffix:
Gender:F
Credentials:M ED, MS,
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:K
Other - Last Name:FRAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:793 OLD ROUTE 119 HWY NORTH
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701
Mailing Address - Country:US
Mailing Address - Phone:724-465-5576
Mailing Address - Fax:
Practice Address - Street 1:600 LEONARD ST.
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830
Practice Address - Country:US
Practice Address - Phone:814-765-5337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor