Provider Demographics
NPI:1154147148
Name:MORENO, SARAH ABIGAIL (MS, BCBA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ABIGAIL
Last Name:MORENO
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 DENTON DR
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-3319
Mailing Address - Country:US
Mailing Address - Phone:979-212-1137
Mailing Address - Fax:
Practice Address - Street 1:809 DENTON DR
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76039-3319
Practice Address - Country:US
Practice Address - Phone:979-212-1137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7721103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst