Provider Demographics
NPI:1396352191
Name:SANDOS, JODI SUE (MSW)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:SUE
Last Name:SANDOS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 LARK LN
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-1907
Mailing Address - Country:US
Mailing Address - Phone:484-995-3701
Mailing Address - Fax:
Practice Address - Street 1:1611 LARK LN
Practice Address - Street 2:
Practice Address - City:VILLANOVA
Practice Address - State:PA
Practice Address - Zip Code:19085-1907
Practice Address - Country:US
Practice Address - Phone:484-995-3701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical