Healthcare Provider Details

I. General information

NPI: 1053074971
Provider Name (Legal Business Name): SARA NICOLE HINKLE BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2021
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 ELBRIDGE PAYNE RD STE 1300
CHESTERFIELD MO
63017-8538
US

IV. Provider business mailing address

1415 ELBRIDGE PAYNE RD STE 1300
CHESTERFIELD MO
63017-8538
US

V. Phone/Fax

Practice location:
  • Phone: 636-898-2080
  • Fax: 636-898-2082
Mailing address:
  • Phone: 636-898-2080
  • Fax: 636-898-2082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number2019042091
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: