Healthcare Provider Details

I. General information

NPI: 1457742868
Provider Name (Legal Business Name): SARAH NELL LADER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2015
Last Update Date: 06/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 MAIN ST STE 300
COLUMBIA SC
29201
US

IV. Provider business mailing address

1505 BLANDING ST
COLUMBIA SC
29201-2906
US

V. Phone/Fax

Practice location:
  • Phone: 803-292-4220
  • Fax:
Mailing address:
  • Phone: 803-929-0011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: