Provider Demographics
NPI:1699558627
Name:STENGEL, SANDRA ANN (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:ANN
Last Name:STENGEL
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 W 42ND ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-1609
Mailing Address - Country:US
Mailing Address - Phone:301-704-8652
Mailing Address - Fax:
Practice Address - Street 1:3706 CRONDALL LN STE 110
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-2235
Practice Address - Country:US
Practice Address - Phone:301-704-8652
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLBA494103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst