Provider Demographics
NPI:1740444363
Name:HARRIS, SARA CAMPBELL (MA, BCBA)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:CAMPBELL
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 GREENVALE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5145
Mailing Address - Country:US
Mailing Address - Phone:410-644-3570
Mailing Address - Fax:
Practice Address - Street 1:3615 GREENVALE RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5145
Practice Address - Country:US
Practice Address - Phone:410-644-3570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-13
Last Update Date:2008-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist