MEDICARE: MS. JOYCE ELIZABETH SANFORD MS CCC-SLP

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	235Z00000X	Speech-Language Pathologist	22003609A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467474304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOYCE ELIZABETH SANFORD MS CCC-SLP

Provider Business Mailing Address
First Line	:	1116 NORTH ST
Second Line	:	APARTMENT A
City	:	LAFAYETTE
State	:	IN
Zip	:	47904-4046
Country	:	US
Telephone Number	:	765-714-2500
Fax Number	:	765-269-9907

Provider Business Practice Location Address
First Line	:	1116 NORTH ST
Second Line	:	APARTMENT A
City	:	LAFAYETTE
State	:	IN
Zip	:	47904-4046
Country	:	US
Telephone Number	:	765-714-2500
Fax Number	:	765-269-9907

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

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	10/07/2013

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Directions to “ MS. JOYCE ELIZABETH SANFORD MS CCC-SLP” Practice Location

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