MEDICARE: SARAH ANN WILLIFORD BCBA

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
1	246ZX2200X	Orthopedic Assistant	AL4491	FL
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1427505163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ANN WILLIFORD BCBA

Provider Business Mailing Address
First Line	:	5597 N DIXIE HWY
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33334-3406
Country	:	US
Telephone Number	:	954-958-4800
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 STELLHORN RD STE I148
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46815-4697
Country	:	US
Telephone Number	:	844-525-5226
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2016
Last Update Date	:	08/22/2022

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Directions to “ SARAH ANN WILLIFORD BCBA” Practice Location

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