MEDICARE: SARAH MCLEAN ARCHER M.A., 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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1629745880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MCLEAN ARCHER M.A., BCBA

Provider Business Mailing Address
First Line	:	207 46TH AVE N
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37209-3521
Country	:	US
Telephone Number	:	769-798-0668
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 GREAT CIRCLE RD
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37228-1707
Country	:	US
Telephone Number	:	615-331-1141
Fax Number	:

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

Provider Enumeration Date	:	08/25/2021
Last Update Date	:	08/25/2021

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