Provider Demographics
NPI:1811567050
Name:SADAR, MIRANDA MEGAN (BCBA)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:MEGAN
Last Name:SADAR
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 1:835 S LILAC ST
Mailing Address - Street 2:
Mailing Address - City:MILLIKEN
Mailing Address - State:CO
Mailing Address - Zip Code:80543-9475
Mailing Address - Country:US
Mailing Address - Phone:303-895-5877
Mailing Address - Fax:
Practice Address - Street 1:835 S LILAC ST
Practice Address - Street 2:
Practice Address - City:MILLIKEN
Practice Address - State:CO
Practice Address - Zip Code:80543-9475
Practice Address - Country:US
Practice Address - Phone:303-895-5877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-21-50904103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty