Provider Demographics
NPI:1083110175
Name:FAVILLA, SARAH ELIZABETH (MA, LBA, BCBA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELIZABETH
Last Name:FAVILLA
Suffix:
Gender:F
Credentials:MA, LBA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7960 US HIGHWAY 287 E
Mailing Address - Street 2:
Mailing Address - City:CORRIGAN
Mailing Address - State:TX
Mailing Address - Zip Code:75939-9000
Mailing Address - Country:US
Mailing Address - Phone:717-209-0052
Mailing Address - Fax:
Practice Address - Street 1:7960 US HIGHWAY 287 E
Practice Address - Street 2:
Practice Address - City:CORRIGAN
Practice Address - State:TX
Practice Address - Zip Code:75939-9000
Practice Address - Country:US
Practice Address - Phone:717-209-0052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2799103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst