Provider Demographics
NPI:1144622820
Name:ROXAS, SANDRA M (MA, CRC, LAC)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:M
Last Name:ROXAS
Suffix:
Gender:F
Credentials:MA, CRC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2396
Mailing Address - Street 2:
Mailing Address - City:SACATON
Mailing Address - State:AZ
Mailing Address - Zip Code:85147-0071
Mailing Address - Country:US
Mailing Address - Phone:480-815-9166
Mailing Address - Fax:
Practice Address - Street 1:HC 3 BOX 1090
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-8633
Practice Address - Country:US
Practice Address - Phone:520-850-8396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor