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NPI Code Detail

MEDICARE: SARA CALLAGHAN

MEDICARE: SARA CALLAGHAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106E00000XAssistant Behavior Analyst

General Provider Information

NPI Number : 1033619341
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA CALLAGHAN
Provider Business Mailing Address
First Line : 6060 N COLLEGE AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46220-1907
Country : US
Telephone Number : 317-584-5166
Fax Number : 317-815-3861
Provider Business Practice Location Address
First Line : 3948 NEW VISION DR STE D
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1721
Country : US
Telephone Number : 260-245-1455
Fax Number : 317-815-3861
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2018
Last Update Date : 04/24/2019

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Directions to “ SARA CALLAGHAN ” Practice Location

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