Provider Demographics
NPI:1497057830
Name:MEMBRIO, SANDRA JONES (CAC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:JONES
Last Name:MEMBRIO
Suffix:
Gender:F
Credentials:CAC
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:JONE
Other - Last Name:MEMBRINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CAC
Mailing Address - Street 1:91 DOWLIN FORGE RD
Mailing Address - Street 2:C.A.R.E, INC.
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1548
Mailing Address - Country:US
Mailing Address - Phone:610-524-2448
Mailing Address - Fax:610-524-0130
Practice Address - Street 1:91 DOWLIN FORGE RD
Practice Address - Street 2:C.A.R.A., INC
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1548
Practice Address - Country:US
Practice Address - Phone:610-524-2448
Practice Address - Fax:610-524-0130
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6588101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)