Provider Demographics
NPI:1710607882
Name:MOYER, SARAH JUNE (MA, BCBA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:JUNE
Last Name:MOYER
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JUNE
Other - Last Name:KLOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:170 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8890
Mailing Address - Country:US
Mailing Address - Phone:570-898-4854
Mailing Address - Fax:
Practice Address - Street 1:45 ROUTE 11
Practice Address - Street 2:
Practice Address - City:SHAMOKIN DAM
Practice Address - State:PA
Practice Address - Zip Code:17876-9116
Practice Address - Country:US
Practice Address - Phone:570-931-3849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-47360103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst