Provider Demographics
NPI:1699083386
Name:LONARDO, SANDRA LEE (SANDRA LONARDO)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:LEE
Last Name:LONARDO
Suffix:
Gender:F
Credentials:SANDRA LONARDO
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:LONARDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SANDRA LONARDO
Mailing Address - Street 1:11 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-1702
Mailing Address - Country:US
Mailing Address - Phone:401-944-6395
Mailing Address - Fax:401-732-6479
Practice Address - Street 1:1639 POST RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-5959
Practice Address - Country:US
Practice Address - Phone:401-736-5500
Practice Address - Fax:401-732-6479
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW020221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical