Provider Demographics
NPI:1801019591
Name:TEMPLE, SANDRA JUNE
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:JUNE
Last Name:TEMPLE
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 1:737 N WEST ST
Mailing Address - Street 2:APT 211
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-1067
Mailing Address - Country:US
Mailing Address - Phone:937-840-7421
Mailing Address - Fax:
Practice Address - Street 1:737 N WEST ST
Practice Address - Street 2:APT 211
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-1067
Practice Address - Country:US
Practice Address - Phone:937-840-7421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide