Provider Demographics
NPI:1952175788
Name:MILES, SARAH ALLISON (RBT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ALLISON
Last Name:MILES
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 OLD FORGE RD
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-9753
Mailing Address - Country:US
Mailing Address - Phone:919-805-2098
Mailing Address - Fax:866-568-8043
Practice Address - Street 1:418 OLD FORGE RD
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-9753
Practice Address - Country:US
Practice Address - Phone:919-805-2098
Practice Address - Fax:866-568-8043
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORBT-23-273450106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician