Provider Demographics
NPI:1710083167
Name:BHARGAVA, SANDY (MS)
Entity Type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:
Last Name:BHARGAVA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 A ST
Mailing Address - Street 2:STE. 104
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-5145
Mailing Address - Country:US
Mailing Address - Phone:907-272-5500
Mailing Address - Fax:907-277-0985
Practice Address - Street 1:1600 A ST
Practice Address - Street 2:STE. 104
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-5145
Practice Address - Country:US
Practice Address - Phone:907-272-5500
Practice Address - Fax:907-277-0985
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional