Provider Demographics
NPI:1932424728
Name:DELAY, SANDRA JEAN (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MISS
First Name:SANDRA
Middle Name:JEAN
Last Name:DELAY
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:MISS
Other - First Name:SANDRA
Other - Middle Name:JEAN
Other - Last Name:DONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:335 BEN TITUS RD
Mailing Address - Street 2:
Mailing Address - City:TAMAQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18252-4825
Mailing Address - Country:US
Mailing Address - Phone:570-985-3350
Mailing Address - Fax:
Practice Address - Street 1:1666 MOUNT HOPE AVE
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-1302
Practice Address - Country:US
Practice Address - Phone:570-622-2525
Practice Address - Fax:570-628-4572
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist