Healthcare Provider Details

I. General information

NPI: 1487057410
Provider Name (Legal Business Name): SARA MALONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2014
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 MCKNIGHT DR
KNIGHTDALE NC
27545-7741
US

IV. Provider business mailing address

5214 SLEEPY FALLS RUN
KNIGHTDALE NC
27545-5100
US

V. Phone/Fax

Practice location:
  • Phone: 919-739-2485
  • Fax:
Mailing address:
  • Phone: 984-480-6751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1033
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: