1437657947 NPI number — MRS. SARAH BROOKE BEDELL BCBA, LBA (M.S.)

Table of content: MRS. SARAH BROOKE BEDELL BCBA, LBA (M.S.) (NPI 1437657947)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437657947 NPI number — MRS. SARAH BROOKE BEDELL BCBA, LBA (M.S.)

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEDELL
Provider First Name:
SARAH
Provider Middle Name:
BROOKE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
BCBA, LBA (M.S.)
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437657947
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/17/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1306
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEMMES
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36575-1306
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-410-5867
Provider Business Mailing Address Fax Number:
251-410-5968

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
THE LEARNING TREE, INC
Provider Second Line Business Practice Location Address:
2185 NORMANDIE DRIVE
Provider Business Practice Location Address City Name:
MONTGOMERY
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36111-2728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-612-7797
Provider Business Practice Location Address Fax Number:
334-283-2350
Provider Enumeration Date:
01/30/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103K00000X , with the licence number: BCBA1-17-28398 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com