MEDICARE: SARA JOAN KROHN

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	103K00000X	Behavior Analyst	695	NC
2	103K00000X	Behavior Analyst	576237	SC
3	106S00000X	Behavior Technician		MN

General Provider Information

NPI Number	:	1912548298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA JOAN KROHN

Provider Business Mailing Address
First Line	:	PO BOX 749
Second Line	:
City	:	BELMONT
State	:	NC
Zip	:	28012-0749
Country	:	US
Telephone Number	:	704-869-2088
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 COPPERFIELD BLVD NE
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-2404
Country	:	US
Telephone Number	:	704-706-2200
Fax Number	:	980-334-2110

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

Provider Enumeration Date	:	10/08/2019
Last Update Date	:	01/07/2026

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Directions to “ SARA JOAN KROHN ” Practice Location

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