Provider Demographics
NPI:1427505163
Name:WILLIFORD, SARAH ANN (BCBA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANN
Last Name:WILLIFORD
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5597 N DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3406
Mailing Address - Country:US
Mailing Address - Phone:954-958-4800
Mailing Address - Fax:
Practice Address - Street 1:3201 STELLHORN RD STE I148
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46815-4697
Practice Address - Country:US
Practice Address - Phone:844-525-5226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-09
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL4491246ZX2200X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No246ZX2200XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherOrthopedic Assistant