Provider Demographics
NPI:1275834442
Name:ESTLE, SARA J (PHD, BCBA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:J
Last Name:ESTLE
Suffix:
Gender:F
Credentials:PHD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 TURF CT
Mailing Address - Street 2:
Mailing Address - City:WEBSTER GROVES
Mailing Address - State:MO
Mailing Address - Zip Code:63119-4619
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19 LEXINGTON OAKS CT
Practice Address - Street 2:
Practice Address - City:FORISTELL
Practice Address - State:MO
Practice Address - Zip Code:63348-1479
Practice Address - Country:US
Practice Address - Phone:636-673-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst