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General NPI Number Information
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NPI Number | 1477806974
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Entity Type | Individual
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Provider Name | ASHLEY ANN SANFORD M.S. OT/L
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Gender | Female
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 420 GAFFNEY DR
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City | WATERTOWN
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State | NY
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Zip | 13601-1823
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Country | US
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Telephone | 315-836-1231
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Fax |
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Provider Business Mailing Address
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Address Line | 41637 STATE ROUTE 180
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City | CLAYTON
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State | NY
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Zip | 13624-2179
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Country | US
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Telephone | 315-783-1950
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Fax |
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 017647
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License Number State | NY
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