Provider Demographics
NPI:1457945271
Name:FOREMAN, SANDRA BURGESS (LBSW)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:BURGESS
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 REDCEDAR DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-8180
Mailing Address - Country:US
Mailing Address - Phone:214-205-4706
Mailing Address - Fax:
Practice Address - Street 1:1735 REDCEDAR DR
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-8180
Practice Address - Country:US
Practice Address - Phone:214-205-4706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator