Provider Demographics
NPI:1285985895
Name:SANDOVA;, MARIA ERIKA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ERIKA
Last Name:SANDOVA;
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 1:1700 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-5134
Mailing Address - Country:US
Mailing Address - Phone:970-353-3370
Mailing Address - Fax:
Practice Address - Street 1:1700 18TH AVE
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-5134
Practice Address - Country:US
Practice Address - Phone:970-353-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant