Provider Demographics
NPI:1710608203
Name:CARDENAS, SANDRA M (MS)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:CARDENAS
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 1:6220 NW 173RD ST APT 705
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-4557
Mailing Address - Country:US
Mailing Address - Phone:786-662-9350
Mailing Address - Fax:
Practice Address - Street 1:6220 NW 173RD ST APT 705
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-4557
Practice Address - Country:US
Practice Address - Phone:786-662-9350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-05
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health