Provider Demographics
NPI:1851658751
Name:HALE, SANDRA J (STNA)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:J
Last Name:HALE
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 TURNEY RD
Mailing Address - Street 2:#320
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146
Mailing Address - Country:US
Mailing Address - Phone:216-338-0256
Mailing Address - Fax:
Practice Address - Street 1:630 TURNEY RD
Practice Address - Street 2:#320
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146
Practice Address - Country:US
Practice Address - Phone:216-338-0256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide