Provider Demographics
NPI:1871858712
Name:REIMONDO, SARAH MARIE (BCBA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:REIMONDO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:ELLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13000 VISTA DEL NORTE
Mailing Address - Street 2:APT 1424
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-8038
Mailing Address - Country:US
Mailing Address - Phone:210-526-1806
Mailing Address - Fax:210-547-7984
Practice Address - Street 1:13000 VISTA DEL NORTE
Practice Address - Street 2:APT 1424
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-8038
Practice Address - Country:US
Practice Address - Phone:210-526-1806
Practice Address - Fax:210-547-7984
Is Sole Proprietor?:No
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-12-11702103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst