Provider Demographics
NPI:1245603513
Name:HAGGARD, SARA (BA)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HAGGARD
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MINDFUL COACHING WITH SARAS
Mailing Address - Street 2:12359 164TH CT NE
Mailing Address - City:REDMONF
Mailing Address - State:WA
Mailing Address - Zip Code:98052
Mailing Address - Country:US
Mailing Address - Phone:415-341-4272
Mailing Address - Fax:
Practice Address - Street 1:18311 BOTHELL EVERETT HWY STE 260
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98012-5233
Practice Address - Country:US
Practice Address - Phone:206-437-5412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-08
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABA61037145103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst