Provider Demographics
NPI:1447700273
Name:SANGER, KAYLEY (PHD, BCBA-D)
Entity type:Individual
Prefix:
First Name:KAYLEY
Middle Name:
Last Name:SANGER
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 E GADSDEN ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-4126
Mailing Address - Country:US
Mailing Address - Phone:614-282-9895
Mailing Address - Fax:
Practice Address - Street 1:7400 BEAUFONT SPRINGS DR STE 300
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23225-5519
Practice Address - Country:US
Practice Address - Phone:888-436-8836
Practice Address - Fax:860-955-1611
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
AL2379103T00000X
MS631181103TC0700X
VA0810008257103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical