Provider Demographics
NPI:1700572617
Name:SAZO, LAURA FIONA (BCBA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:FIONA
Last Name:SAZO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 BROOKSIDE ACRES RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN REST
Mailing Address - State:SC
Mailing Address - Zip Code:29664-9600
Mailing Address - Country:US
Mailing Address - Phone:864-309-9914
Mailing Address - Fax:
Practice Address - Street 1:8 APPALACHIAN LN
Practice Address - Street 2:
Practice Address - City:MAULDIN
Practice Address - State:SC
Practice Address - Zip Code:29662-1800
Practice Address - Country:US
Practice Address - Phone:864-982-4577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCBACB420380103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst