Provider Demographics
NPI:1619607462
Name:MERTEL, SARA (PHD, BCBA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:MERTEL
Suffix:
Gender:F
Credentials:PHD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 E MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3901
Mailing Address - Country:US
Mailing Address - Phone:602-237-6653
Mailing Address - Fax:
Practice Address - Street 1:3202 E MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3901
Practice Address - Country:US
Practice Address - Phone:602-237-6653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst