Healthcare Provider Details

I. General information

NPI: 1972140291
Provider Name (Legal Business Name): SARAH BOYLES BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2019
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 COLLEGE BLVD E.
NICEVILLE FL
32578-1343
US

IV. Provider business mailing address

80 COLLEGE BLVD E.
NICEVILLE FL
32578-1343
US

V. Phone/Fax

Practice location:
  • Phone: 850-279-3000
  • Fax: 850-389-2269
Mailing address:
  • Phone: 850-279-3000
  • Fax: 850-389-2269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-4555-186462
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-25-16698
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: