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General NPI Number Information
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NPI Number | 1861013518
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Entity Type | Individual
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Provider Name | SARAH RENAE GREENE BCBA, LBA
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Gender | Female
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Dates
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Enumeration Date | 05/05/2020
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 1280 COLUMBIANA RD
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City | VESTAVIA HILLS
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State | AL
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Zip | 35216-1603
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Country | US
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Telephone | 205-234-4763
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Fax |
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Provider Business Mailing Address
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Address Line | 1456 NAVAJO TRL
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City | ALABASTER
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State | AL
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Zip | 35007-9003
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Country | US
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Telephone | 205-253-6903
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-19-105557
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License Number State | AL
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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 | 2022-071
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License Number State | AL
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