Healthcare Provider Details

I. General information

NPI: 1548968613
Provider Name (Legal Business Name): SARAH MARIE BURDICK BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH MARIE BOSGRA BCBA

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 S MAIN ST FL 1
GREENVILLE SC
29601-2923
US

IV. Provider business mailing address

7108 S KANNER HWY
STUART FL
34997-7462
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax: 772-675-9100
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBACB626928
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: