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NPI Code Detail

MEDICARE: SARA RICHARDS MA, LLP, BCBA, LBA

MEDICARE: SARA RICHARDS MA, LLP, BCBA, LBA
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
1103TC0700XClinical Psychologist6301016357MI
2103K00000XBehavior Analyst11934873MI

General Provider Information

NPI Number : 1386045136
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA RICHARDS MA, LLP, BCBA, LBA
Provider Business Mailing Address
First Line : 4953 SCHAEFER RD
Second Line :
City : DEARBORN
State : MI
Zip : 48126-3260
Country : US
Telephone Number : 313-551-5788
Fax Number :
Provider Business Practice Location Address
First Line : 4953 SCHAEFER RD
Second Line :
City : DEARBORN
State : MI
Zip : 48126-3260
Country : US
Telephone Number : 313-551-5788
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2014
Last Update Date : 10/21/2022

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