Provider Demographics
NPI:1568026664
Name:HOGAN, SARA (BCBA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HOGAN
Suffix:
Gender:F
Credentials: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 1139
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-0019
Mailing Address - Country:US
Mailing Address - Phone:936-441-2200
Mailing Address - Fax:936-570-9088
Practice Address - Street 1:304 W MILL ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-3227
Practice Address - Country:US
Practice Address - Phone:936-441-2200
Practice Address - Fax:936-570-9088
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-18-33532103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst