Individual
MRS. SANDRA ELLEN VANGILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4555 N RIDGEWOOD DR, BLOOMINGTON, IN 47404-8924
(815) 219-2260
Mailing address
4555 N RIDGEWOOD DR, BLOOMINGTON, IN 47404-8924
(815) 219-2260
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
33009441A
IN
Other
Enumeration date
08/19/2022
Last updated
08/19/2022
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