Provider Demographics
NPI:1912702903
Name:SANFORD, RACHEL RENEE (BACHELORS OF SCIENCE)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:RENEE
Last Name:SANFORD
Suffix:
Gender:F
Credentials:BACHELORS OF SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2250 THUNDERSTICK DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505-9010
Mailing Address - Country:US
Mailing Address - Phone:859-254-1035
Mailing Address - Fax:
Practice Address - Street 1:523 PEACHTREE RD
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-2388
Practice Address - Country:US
Practice Address - Phone:859-551-5937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator