Provider Demographics
NPI:1700388618
Name:LING, SANDRA M (MED)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:M
Last Name:LING
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 MACKEY KEY DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-8190
Mailing Address - Country:US
Mailing Address - Phone:850-291-1731
Mailing Address - Fax:
Practice Address - Street 1:2045 MACKEY KEY DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-8190
Practice Address - Country:US
Practice Address - Phone:850-291-1731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist