Provider Demographics
NPI:1700207040
Name:FOREMAN, SARAH (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SUBURBAN AVE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-3038
Mailing Address - Country:US
Mailing Address - Phone:814-883-3783
Mailing Address - Fax:
Practice Address - Street 1:105 SUBURBAN AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-3038
Practice Address - Country:US
Practice Address - Phone:814-883-3783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-13-14890103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst