Provider Demographics
NPI:1548463375
Name:SANFORD, GARICA
Entity type:Individual
Prefix:
First Name:GARICA
Middle Name:
Last Name:SANFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:GARICA
Other - Middle Name:
Other - Last Name:SANFORD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:14673 MIDWAY RD
Mailing Address - Street 2:213
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-3171
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14673 MIDWAY RD
Practice Address - Street 2:213
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-3171
Practice Address - Country:US
Practice Address - Phone:972-885-7165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36391103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist