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General NPI Number Information
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NPI Number | 1013470483
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Entity Type | Organization
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Legal Business Name | SANGER AND ASSOCIATES - BEHAVIORAL AND PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 04/11/2019
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 2780 VERANDAH VUE WAY
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City | LAKELAND
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State | FL
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Zip | 33812
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Country | US
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Telephone | 863-944-0841
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Fax | 863-583-0480
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Provider Business Mailing Address
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Address Line | 2780 VERANDAH VUE WAY
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City | LAKELAND
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State | FL
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Zip | 33812
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Country | US
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Telephone | 863-944-0841
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Fax | 863-583-0480
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | KEVIN SANGER
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Credential | ED.S, LSP, BCBA
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Telephone | 863-944-0841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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