Provider Demographics
NPI:1255169447
Name:SIMANOVICH, SARAH (RBT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:SIMANOVICH
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 TUTOR LN STE 107
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-7295
Mailing Address - Country:US
Mailing Address - Phone:812-602-1038
Mailing Address - Fax:812-602-1048
Practice Address - Street 1:556 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DALE
Practice Address - State:IN
Practice Address - Zip Code:47523
Practice Address - Country:US
Practice Address - Phone:812-937-6559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-24-363433106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician