Individual
SANDRA DESILVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
225 LAZY HOLLOW LN, COVINGTON, GA 30016-4504
(631) 338-3478
Mailing address
225 LAZY HOLLOW LN, COVINGTON, GA 30016-4504
(631) 338-3478
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
059313640
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN0014197201
CNA
GA
Enumeration date
03/25/2019
Last updated
03/25/2019
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