Individual
MICHELLE SANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
215 5TH AVE, ANDALUSIA, AL 36420-3260
(334) 208-6494
Mailing address
510 W 10TH ST, LYNN HAVEN, FL 32444-2329
(803) 381-3309
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-82902
AL
Other
Enumeration date
04/07/2019
Last updated
04/07/2019
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