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General NPI Number Information
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NPI Number | 1538563796
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Entity Type | Individual
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Provider Name | SARAH ROLDAN PEDEN MS, BCBA
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Gender | Female
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 2115 10TH AVE N
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City | LAKE WORTH BEACH
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State | FL
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Zip | 33461-3345
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Country | US
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Telephone | 561-506-3665
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Fax |
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Provider Business Mailing Address
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Address Line | 13086 83RD LN N
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City | WEST PALM BEACH
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State | FL
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Zip | 33412-2671
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Country | US
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Telephone | 305-796-7342
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | FL
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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 | FL
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