Provider Demographics
NPI:1891105078
Name:ROY, SANDRA LEE (ND)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LEE
Last Name:ROY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:964 ELKLAND PL
Mailing Address - Street 2:APT. 2
Mailing Address - City:VENICE
Mailing Address - State:CA
Mailing Address - Zip Code:90291-3563
Mailing Address - Country:US
Mailing Address - Phone:954-415-7826
Mailing Address - Fax:
Practice Address - Street 1:964 ELKLAND PL
Practice Address - Street 2:APT. 2
Practice Address - City:VENICE
Practice Address - State:CA
Practice Address - Zip Code:90291-3563
Practice Address - Country:US
Practice Address - Phone:954-415-7826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANDF609175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath