Provider Demographics
NPI:1528606407
Name:SAUCEDO, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SAUCEDO
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 1:9600 GREAT HILLS TRL
Mailing Address - Street 2:SUITE 150W
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-6387
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9600 GREAT HILLS TRL
Practice Address - Street 2:SUITE 150W
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-6387
Practice Address - Country:US
Practice Address - Phone:303-989-8169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician