Provider Demographics
NPI:1851265938
Name:SANDOVAL, SARAH MARYA
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:MARYA
Last Name:SANDOVAL
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 1:521 BENCO CT
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-5102
Mailing Address - Country:US
Mailing Address - Phone:708-712-4014
Mailing Address - Fax:
Practice Address - Street 1:10033 WICKER AVE STE 7&8
Practice Address - Street 2:
Practice Address - City:SAINT JOHN
Practice Address - State:IN
Practice Address - Zip Code:46373-8776
Practice Address - Country:US
Practice Address - Phone:219-266-6241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist