Provider Demographics
NPI:1386414001
Name:SANZO, DEMAREST ELIZABETH (RBT)
Entity type:Individual
Prefix:
First Name:DEMAREST
Middle Name:ELIZABETH
Last Name:SANZO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:DEMAREST
Other - Middle Name:ELIZABETH
Other - Last Name:SEAGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23 HOSPITAL DR STE 102
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5270
Mailing Address - Country:US
Mailing Address - Phone:325-238-9337
Mailing Address - Fax:
Practice Address - Street 1:23 HOSPITAL DR STE 102
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5270
Practice Address - Country:US
Practice Address - Phone:325-238-9337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-23-305229106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician