Provider Demographics
NPI:1386180156
Name:SANCHEZ, KHABIR SHERALD
Entity Type:Individual
Prefix:
First Name:KHABIR
Middle Name:SHERALD
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10044 VISTA LAGUNA DR APT 206
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-6156
Mailing Address - Country:US
Mailing Address - Phone:407-724-9962
Mailing Address - Fax:
Practice Address - Street 1:10044 VISTA LAGUNA DR APT 206
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-6156
Practice Address - Country:US
Practice Address - Phone:407-724-9962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst