MEDICARE: SARAH ANDREA FERNANDEZ

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	106S00000X	Behavior Technician	BACB1565432	NC

General Provider Information

NPI Number	:	1932037439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ANDREA FERNANDEZ

Provider Business Mailing Address
First Line	:	124 KRISTIN AVE
Second Line	:
City	:	SPRING LAKE
State	:	NC
Zip	:	28390-3176
Country	:	US
Telephone Number	:	706-910-4303
Fax Number	:

Provider Business Practice Location Address
First Line	:	124 KRISTIN AVE
Second Line	:
City	:	SPRING LAKE
State	:	NC
Zip	:	28390-3176
Country	:	US
Telephone Number	:	706-910-4303
Fax Number	:

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

Provider Enumeration Date	:	05/13/2026
Last Update Date	:	05/13/2026

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Directions to “ SARAH ANDREA FERNANDEZ ” Practice Location

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