Provider Demographics
NPI:1710758321
Name:WINFREE, SANDRA DENISE
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:DENISE
Last Name:WINFREE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2203 COBBLESTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7330
Mailing Address - Country:US
Mailing Address - Phone:470-618-9014
Mailing Address - Fax:
Practice Address - Street 1:2203 COBBLESTONE BLVD
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7330
Practice Address - Country:US
Practice Address - Phone:470-618-9014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst