Provider Demographics
NPI:1871920488
Name:CRALEY, SARAH A (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:A
Last Name:CRALEY
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 1:3030 GRAFTON LN
Mailing Address - Street 2:
Mailing Address - City:CHURCHVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21028
Mailing Address - Country:US
Mailing Address - Phone:410-776-4640
Mailing Address - Fax:410-734-4640
Practice Address - Street 1:1106 REVOLUTION ST
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-3721
Practice Address - Country:US
Practice Address - Phone:410-776-4640
Practice Address - Fax:410-734-4640
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-27
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLBA402103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD424617900Medicaid