Provider Demographics
NPI:1982963948
Name:SABBIONI, SANDRA M (LCSW)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:M
Last Name:SABBIONI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:M
Other - Last Name:FRY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW, LMSW
Mailing Address - Street 1:10101 EASTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-6856
Mailing Address - Country:US
Mailing Address - Phone:405-655-8865
Mailing Address - Fax:
Practice Address - Street 1:10101 EASTLAKE DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-6856
Practice Address - Country:US
Practice Address - Phone:405-655-8865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK49941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty