Provider Demographics
NPI:1255575171
Name:SANDERS, SARAH E (MED, BCBA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7053 S 2310 W
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-3009
Mailing Address - Country:US
Mailing Address - Phone:801-414-8004
Mailing Address - Fax:801-255-5131
Practice Address - Street 1:7053 S 2310 W
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-3009
Practice Address - Country:US
Practice Address - Phone:801-414-8004
Practice Address - Fax:801-255-5131
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst