Provider Demographics
NPI:1568617272
Name:BOHON, SANDRA (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:BOHON
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:437 CAROLINA AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-2928
Mailing Address - Country:US
Mailing Address - Phone:407-414-0349
Mailing Address - Fax:
Practice Address - Street 1:804 N HOAGLAND BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4518
Practice Address - Country:US
Practice Address - Phone:407-931-2911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMHC 9302101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health