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NPI Code Detail

MEDICARE: SADIE MCKAY SPAHN I BCBA

MEDICARE: SADIE MCKAY SPAHN I BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1538768494
Entity Type Code : Individual
Provider Name (Legal Business Name) : SADIE MCKAY SPAHN I BCBA
Provider Business Mailing Address
First Line : 6416 NW 5TH WAY
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33309-6112
Country : US
Telephone Number : 888-754-0398
Fax Number :
Provider Business Practice Location Address
First Line : 6140 W EXECUTIVE DR STE B
Second Line :
City : MEQUON
State : WI
Zip : 53092-4499
Country : US
Telephone Number : 888-754-0398
Fax Number : 954-982-6491
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2020
Last Update Date : 06/11/2024

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Directions to “ SADIE MCKAY SPAHN I BCBA” Practice Location

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