Provider Demographics
NPI:1275371866
Name:WILLIAMS, SANDRA KAY (CPRS)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:KAY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 BARNHILL DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-7349
Mailing Address - Country:US
Mailing Address - Phone:330-813-0937
Mailing Address - Fax:
Practice Address - Street 1:427 BARNHILL DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-7349
Practice Address - Country:US
Practice Address - Phone:330-813-0937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS005075175T00000X
OHAPS.005075175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist