Provider Demographics
NPI:1740959253
Name:SANDOVAL, SELINDA C (MBA, BS, NA, HHA)
Entity type:Individual
Prefix:
First Name:SELINDA
Middle Name:C
Last Name:SANDOVAL
Suffix:
Gender:F
Credentials:MBA, BS, NA, HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2822 SEDGEWICK ST NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-2942
Mailing Address - Country:US
Mailing Address - Phone:330-469-4635
Mailing Address - Fax:
Practice Address - Street 1:2822 SEDGEWICK ST NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-2942
Practice Address - Country:US
Practice Address - Phone:330-469-4635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care