Provider Demographics
NPI:1942799952
Name:FAILLA, SADIE MARELLE (BS)
Entity Type:Individual
Prefix:
First Name:SADIE
Middle Name:MARELLE
Last Name:FAILLA
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14088 W CLUB DELUXE RD
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1000
Mailing Address - Country:US
Mailing Address - Phone:985-542-0077
Mailing Address - Fax:
Practice Address - Street 1:14088 W CLUB DELUXE RD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1000
Practice Address - Country:US
Practice Address - Phone:985-542-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-04
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician