Provider Demographics
NPI:1427431816
Name:SABALA, ALEXIE (MED, BCBA)
Entity type:Individual
Prefix:
First Name:ALEXIE
Middle Name:
Last Name:SABALA
Suffix:
Gender:M
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7451 WILES RD STE 107
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2040
Mailing Address - Country:US
Mailing Address - Phone:954-893-2442
Mailing Address - Fax:
Practice Address - Street 1:7451 WILES RD STE 107
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-2040
Practice Address - Country:US
Practice Address - Phone:954-893-2442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2020-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-14-6352103K00000X
1-18-32555103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst