Provider Demographics
NPI:1285179333
Name:DAVIS-LARKINS, SARA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:DAVIS-LARKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2061 CORAL TRACE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445
Mailing Address - Country:US
Mailing Address - Phone:561-265-2461
Mailing Address - Fax:
Practice Address - Street 1:2061 CORAL TRACE CIRCLE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445
Practice Address - Country:US
Practice Address - Phone:561-265-2461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLD124780566640103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst