Provider Demographics
NPI:1518224138
Name:PETITFRERE, SABRINA (BCBA)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:PETITFRERE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:
Other - Last Name:OMEGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:4800 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5746
Mailing Address - Country:US
Mailing Address - Phone:954-532-0337
Mailing Address - Fax:954-208-0680
Practice Address - Street 1:4800 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-5746
Practice Address - Country:US
Practice Address - Phone:954-532-0337
Practice Address - Fax:954-208-0680
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-12-11887103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst