Provider Demographics
NPI:1295609709
Name:THERMIDOR, SANDY
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:THERMIDOR
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 1:1738 THOMASVILLE RD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-5754
Mailing Address - Country:US
Mailing Address - Phone:850-909-5521
Mailing Address - Fax:
Practice Address - Street 1:1738 THOMASVILLE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-5754
Practice Address - Country:US
Practice Address - Phone:850-909-5521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ13069235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist