Provider Demographics
NPI:1851605265
Name:CHAMPAGNE, SARAH PARKS (MA, BCBA)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:PARKS
Last Name:CHAMPAGNE
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 NICHOLAS ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-4124
Mailing Address - Country:US
Mailing Address - Phone:337-249-8279
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 3163
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70602-3163
Practice Address - Country:US
Practice Address - Phone:337-491-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst