Provider Demographics
NPI:1003412891
Name:FLATLAND, SARAH S (BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:S
Last Name:FLATLAND
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:S
Other - Last Name:SMELTZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA, LBA
Mailing Address - Street 1:1473 132ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:WI
Mailing Address - Zip Code:54017-6659
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1427 VIRGINIA LN
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703-0747
Practice Address - Country:US
Practice Address - Phone:715-456-9022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI400-140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst