Provider Demographics
NPI:1477917367
Name:MUSCO, SARA (BCBA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MUSCO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:O'DROBINAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:325 HEMLOCK DR
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-2630
Mailing Address - Country:US
Mailing Address - Phone:219-644-7130
Mailing Address - Fax:
Practice Address - Street 1:1 TEDDY CT
Practice Address - Street 2:
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-2277
Practice Address - Country:US
Practice Address - Phone:219-644-7130
Practice Address - Fax:401-684-0050
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-07
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI1-16-22036103K00000X
RILBA00112103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst