Provider Demographics
NPI:1437674488
Name:SAWYER, TESIA (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:TESIA
Middle Name:
Last Name:SAWYER
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40588-0216
Mailing Address - Country:US
Mailing Address - Phone:859-899-9200
Mailing Address - Fax:
Practice Address - Street 1:1035 STRADER DR STE 150
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505
Practice Address - Country:US
Practice Address - Phone:859-899-9200
Practice Address - Fax:859-899-9202
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-11
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1-17-26054103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst