=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083110175
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH ELIZABETH FAVILLA MA, LBA, BCBA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/05/2018
-----------------------------------------------------
Last Update Date | 10/14/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11111 KATY FWY STE 910
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77079-2119
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-400-9757
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7960 US HIGHWAY 287 E
-----------------------------------------------------
City | CORRIGAN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75939-9000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-209-0052
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | 2799
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------