Provider Demographics
NPI:1568179323
Name:TAJNAI, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:TAJNAI
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:W357N7134 RAINBOW TER
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-1235
Mailing Address - Country:US
Mailing Address - Phone:920-912-3275
Mailing Address - Fax:
Practice Address - Street 1:4125 N 124TH ST STE A
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-1837
Practice Address - Country:US
Practice Address - Phone:920-912-3275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst