Provider Demographics
NPI:1740865971
Name:VACA ANAYA, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:VACA ANAYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 GREENTREE TRL
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-9505
Mailing Address - Country:US
Mailing Address - Phone:501-764-7423
Mailing Address - Fax:
Practice Address - Street 1:113 GREENTREE TRL
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-9505
Practice Address - Country:US
Practice Address - Phone:501-764-7423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician