Provider Demographics
NPI:1780890400
Name:STROUGHTER, SANDRA KAYE
Entity type:Individual
Prefix:MISS
First Name:SANDRA
Middle Name:KAYE
Last Name:STROUGHTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4821 WESTCHESTER DR
Mailing Address - Street 2:APT 120
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515
Mailing Address - Country:US
Mailing Address - Phone:330-207-9337
Mailing Address - Fax:
Practice Address - Street 1:3531 HILLMAN ST.
Practice Address - Street 2:APT 221
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44507
Practice Address - Country:US
Practice Address - Phone:330-788-3424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2301726Medicaid