MEDICARE: SARA LEOVIC RBT

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
1	106S00000X	Behavior Technician	RBT1977982	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619437183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA LEOVIC RBT

Provider Business Mailing Address
First Line	:	1714 SHEA CENTER DR APT 201
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-3525
Country	:	US
Telephone Number	:	720-391-9064
Fax Number	:

Provider Business Practice Location Address
First Line	:	1714 SHEA CENTER DR APT 201
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-3525
Country	:	US
Telephone Number	:	720-391-9064
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2019
Last Update Date	:	03/21/2019

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Directions to “ SARA LEOVIC RBT” Practice Location

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