Provider Demographics
NPI:1790168375
Name:HAYES, SARAH LYNN (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:LYNN
Last Name:HAYES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 LIBRARY BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-1567
Mailing Address - Country:US
Mailing Address - Phone:317-881-9923
Mailing Address - Fax:
Practice Address - Street 1:640 S WALKER ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-2158
Practice Address - Country:US
Practice Address - Phone:812-650-4804
Practice Address - Fax:812-650-4804
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1-15-18709103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst