Provider Demographics
NPI:1235476730
Name:HAFER, SARAH BETH (BCBA)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:BETH
Last Name:HAFER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:BETH
Other - Last Name:JACK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:209 N MILDRED ST
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-1831
Mailing Address - Country:US
Mailing Address - Phone:631-835-9928
Mailing Address - Fax:
Practice Address - Street 1:46 TRIFECTA PL
Practice Address - Street 2:SUITE 105
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-4958
Practice Address - Country:US
Practice Address - Phone:304-725-4536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-03
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst