Provider Demographics
NPI:1497405880
Name:HIRSI, SAHRA (RBT)
Entity Type:Individual
Prefix:
First Name:SAHRA
Middle Name:
Last Name:HIRSI
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 PROSPECTOR TRL
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-2700
Mailing Address - Country:US
Mailing Address - Phone:254-833-3700
Mailing Address - Fax:254-442-8088
Practice Address - Street 1:840 PROSPECTOR TRL
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-2700
Practice Address - Country:US
Practice Address - Phone:254-833-3700
Practice Address - Fax:254-442-8088
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-22-20851106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXRBT-22-208513OtherRBT