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General NPI Number Information
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NPI Number | 1437635026
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Entity Type | Individual
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Provider Name | SARAH ELISE WAINEO MA BCBA LBA
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Gender | Female
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 12200 E 13 MILE RD STE 100
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City | WARREN
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State | MI
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Zip | 48093-3080
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Country | US
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Telephone | 586-573-1814
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Fax |
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Provider Business Mailing Address
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Address Line | 4410 W 13 MILE RD
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City | ROYAL OAK
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State | MI
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Zip | 48073-6515
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Country | US
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Telephone | 847-373-1663
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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