Healthcare Provider Details

I. General information

NPI: 1912289422
Provider Name (Legal Business Name): TONIA SANFORD OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2011
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1946 45TH ST STE A
MUNSTER IN
46321-3956
US

IV. Provider business mailing address

6543 HOHMAN AVE
HAMMOND IN
46324-1021
US

V. Phone/Fax

Practice location:
  • Phone: 219-332-0033
  • Fax: 317-520-8200
Mailing address:
  • Phone: 309-750-9599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056007395
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number31008851A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: