Provider Demographics
NPI:1710571187
Name:MADDOX, SARAH (RBT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MADDOX
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:YINKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:3925 MIDLANDS RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2575
Mailing Address - Country:US
Mailing Address - Phone:757-585-3216
Mailing Address - Fax:757-561-2541
Practice Address - Street 1:3925 MIDLANDS RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2575
Practice Address - Country:US
Practice Address - Phone:757-585-3216
Practice Address - Fax:757-561-2541
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VARBT-20-148324106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician