Provider Demographics
NPI:1902086440
Name:DAY, SANDRA A (BC-HIS)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:A
Last Name:DAY
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-2655
Mailing Address - Country:US
Mailing Address - Phone:802-748-4852
Mailing Address - Fax:
Practice Address - Street 1:198 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-2655
Practice Address - Country:US
Practice Address - Phone:802-748-4852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT063-0000129237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist