Provider Demographics
NPI:1235735655
Name:SANFORD, DIONNE MARIE
Entity Type:Individual
Prefix:
First Name:DIONNE
Middle Name:MARIE
Last Name:SANFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8006 TOWNSEND AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44104-2156
Mailing Address - Country:US
Mailing Address - Phone:216-256-2359
Mailing Address - Fax:
Practice Address - Street 1:8006 TOWNSEND AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44104-2156
Practice Address - Country:US
Practice Address - Phone:216-256-2359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide