Provider Demographics
NPI:1750828448
Name:CORWIN, SARAH ANN (RBT)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:ANN
Last Name:CORWIN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9153 W 133RD ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4333
Mailing Address - Country:US
Mailing Address - Phone:913-257-5185
Mailing Address - Fax:800-687-5070
Practice Address - Street 1:9153 W 133RD ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-4333
Practice Address - Country:US
Practice Address - Phone:913-257-5185
Practice Address - Fax:800-687-5070
Is Sole Proprietor?:No
Enumeration Date:2017-01-19
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60728596106S00000X
WARBT1750828448106S00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician