Individual
SUZANNE WOOD SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
25 REID STREET, CHATHAM, VA 24531
(434) 432-8602
(434) 432-8603
Mailing address
PO BOX 433, CHATHAM, VA 24531-0433
(434) 432-8602
(434) 432-8603
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701003746
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010135702
—
VA
01
—
175433
ANTHEM PROVIDER #
VA
01
—
84122M
SENTARA PROVIDER #
VA
Enumeration date
07/27/2006
Last updated
06/03/2011
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