Provider Demographics
NPI:1710402771
Name:SANFORD, ANNE K (BCBA)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:K
Last Name:SANFORD
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
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Mailing Address - Street 1:1210 FOURIER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1969
Mailing Address - Country:US
Mailing Address - Phone:608-662-9327
Mailing Address - Fax:608-662-9041
Practice Address - Street 1:2125 HEIGHTS DR STE 2F
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6146
Practice Address - Country:US
Practice Address - Phone:715-832-2233
Practice Address - Fax:715-833-1666
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI24-140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst