Individual
FELICIA L. SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, HSPP
Contact information
Practice address
339 ALANA DR, NEW LENOX, IL 60451-1766
(815) 462-3827
(815) 462-3837
Mailing address
339 ALANA DR, NEW LENOX, IL 60451-1766
(815) 462-3827
(815) 462-3837
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
071006987
IL
103TC0700X
Clinical Psychologist
Primary
200424A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000659707
ANTHEM
IN
01
—
09932429
BLUE CROSS BLUE SHIELD
IL
05
—
200991950
—
IN
Enumeration date
08/16/2007
Last updated
02/15/2012
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