Provider Demographics
NPI:1700274511
Name:FELDMAN, SARA PETERMAN (PHD, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:PETERMAN
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:PHD, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 N ALMA DR STE 110
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-4624
Mailing Address - Country:US
Mailing Address - Phone:469-730-0925
Mailing Address - Fax:
Practice Address - Street 1:1220 N ALMA DR STE 110
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-4624
Practice Address - Country:US
Practice Address - Phone:469-730-0925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-31
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-14-10409103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst