Provider Demographics
NPI:1811536824
Name:TABOR, SARAH (BCABA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:TABOR
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:TREACY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10200 NI RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-3741
Mailing Address - Country:US
Mailing Address - Phone:571-305-3831
Mailing Address - Fax:
Practice Address - Street 1:10200 NI RIVER DR
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22553-3741
Practice Address - Country:US
Practice Address - Phone:571-305-3831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst