Healthcare Provider Details

I. General information

NPI: 1245743848
Provider Name (Legal Business Name): SASHA KAY BCABA, LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2017
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 COLLEGE AVE NE
GRAND RAPIDS MI
49503-1710
US

IV. Provider business mailing address

5814 20TH AVE SE
LACEY WA
98503-2802
US

V. Phone/Fax

Practice location:
  • Phone: 910-922-2330
  • Fax:
Mailing address:
  • Phone: 910-922-2330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: