Healthcare Provider Details

I. General information

NPI: 1740896620
Provider Name (Legal Business Name): SARAH PESHEL BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4912 WALKER CIR
JOHNSTON IA
50131-2535
US

IV. Provider business mailing address

701 BELL AVE
DES MOINES IA
50315-1934
US

V. Phone/Fax

Practice location:
  • Phone: 515-664-3422
  • Fax:
Mailing address:
  • Phone: 319-654-4363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: