Provider Demographics
NPI:1164665253
Name:SCANTLING, SANDRA (PSYD, APRN)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:SCANTLING
Suffix:
Gender:F
Credentials:PSYD, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:778 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2342
Mailing Address - Country:US
Mailing Address - Phone:860-677-1910
Mailing Address - Fax:
Practice Address - Street 1:778 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2342
Practice Address - Country:US
Practice Address - Phone:860-677-1910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001831103TC0700X
MA001186163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical