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General NPI Number Information
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NPI Number | 1962882860
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Entity Type | Individual
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Provider Name | SABRINA SUE DANIELSON BCBA
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Gender | Female
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 08/21/2020
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Provider Practice Location Address
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Address Line | 43299 SE PORTER RD
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City | ESTACADA
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State | OR
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Zip | 97023-9549
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Country | US
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Telephone | 619-305-5657
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Fax |
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Provider Business Mailing Address
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Address Line | 43299 SE PORTER RD
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City | ESTACADA
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State | OR
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Zip | 97023-9549
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Country | US
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Telephone | 619-305-5657
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 14-00235
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License Number State | CA
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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 | ABA-B-10191598
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License Number State | OR
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