Healthcare Provider Details

I. General information

NPI: 1871115675
Provider Name (Legal Business Name): SARA B GAYLER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2020
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 LIGHT STREET, BALTIMORE, MD, USA 2101
BALTIMORE MD
21202-2120
US

IV. Provider business mailing address

1111 UNIVERSITY BLVD W APT 210
SILVER SPRING MD
20902-3315
US

V. Phone/Fax

Practice location:
  • Phone: 386-767-3752
  • Fax:
Mailing address:
  • Phone: 240-945-9774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-71110
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-20-125443
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: