MEDICARE: WILLIAM SANFORD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1437863834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM SANFORD

Provider Business Mailing Address
First Line	:	215 E POE RD APT 66
Second Line	:
City	:	BOWLING GREEN
State	:	OH
Zip	:	43402-1373
Country	:	US
Telephone Number	:	951-880-7433
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 LEHMAN AVE STE 100
Second Line	:
City	:	BOWLING GREEN
State	:	OH
Zip	:	43402-3068
Country	:	US
Telephone Number	:	951-880-7433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2023
Last Update Date	:	01/10/2023

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Directions to “ WILLIAM SANFORD ” Practice Location

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