Provider Demographics
NPI:1699280958
Name:BAEZ, SARAH (NCSP)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BAEZ
Suffix:
Gender:F
Credentials:NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3568 GERAGHTY AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-4701
Mailing Address - Country:US
Mailing Address - Phone:907-374-7001
Mailing Address - Fax:907-374-7008
Practice Address - Street 1:3568 GERAGHTY AVE
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4701
Practice Address - Country:US
Practice Address - Phone:907-374-7001
Practice Address - Fax:907-374-7008
Is Sole Proprietor?:No
Enumeration Date:2017-12-08
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
43015103TS0200X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician