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General NPI Number Information
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NPI Number | 1770198731
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Entity Type | Individual
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Provider Name | SARA WAIS
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Gender | Female
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 1717 E CARY ST
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City | RICHMOND
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State | VA
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Zip | 23223-7024
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Country | US
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Telephone | 804-215-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 1925 W RIVER RD APT 5207
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City | TUCSON
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State | AZ
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Zip | 85704-1678
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Country | US
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Telephone | 925-822-4267
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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 | 0133003030
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License Number State | VA
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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 | 7970
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License Number State | TX
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