Provider Demographics
NPI:1891153763
Name:TEMBY, SANDRA LILIANA
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LILIANA
Last Name:TEMBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:LILIANA
Other - Last Name:MORALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4420 S 108TH ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53228-2505
Mailing Address - Country:US
Mailing Address - Phone:414-383-4486
Mailing Address - Fax:414-235-3453
Practice Address - Street 1:4420 S 108TH ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53228-2505
Practice Address - Country:US
Practice Address - Phone:414-383-4486
Practice Address - Fax:414-235-3453
Is Sole Proprietor?:No
Enumeration Date:2016-02-05
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator