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General NPI Number Information
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NPI Number | 1306943345
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Entity Type | Individual
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Provider Name | REBECA J SANDOVAL LSCSW
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/12/2012
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Provider Practice Location Address
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Address Line | 127 E AVENUE B STE B
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City | HUTCHINSON
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State | KS
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Zip | 67501-7422
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Country | US
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Telephone | 620-259-7993
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Fax | 620-259-7994
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Provider Business Mailing Address
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Address Line | 127 E AVENUE B STE B
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City | HUTCHINSON
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State | KS
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Zip | 67501-7422
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Country | US
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Telephone | 620-259-7993
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Fax | 620-259-7994
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 3874
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License Number State | KS
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