Healthcare Provider Details
I. General information
NPI: 1598460214
Provider Name (Legal Business Name): SARAH FELICIA BANZHAF
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/03/2023
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
400 E PRATT ST FL 8
BALTIMORE MD
21202-3180
US
IV. Provider business mailing address
3143 PINE ORCHARD LN APT 401
ELLICOTT CITY MD
21042-4260
US
V. Phone/Fax
- Phone: 866-872-7601
- Fax:
- Phone: 443-652-7698
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | LBA1833 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: