Sadi Boswell
Individual provider Active NPI Behavior Technician · Elba, AL
NPI 1114773231 · NPPES record last updated Apr 29, 2024
Key facts
- NPI
- 1114773231
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- License
- RBT-24-328756 (AL)
- Practice address
- 1280 Forest Lake Dr
Elba, AL 36323-1440 - Phone
- (334) 482-2999
- NPI assigned
- Apr 29, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RBT-24-328756 | AL | MD | Behavior Technician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-24-328756 | AL | Yes |
Addresses
Primary practice location
1280 Forest Lake Dr
Elba, AL 36323-1440
Mailing address
1280 Forest Lake Dr
Elba, AL 36323-1440
Other providers in Elba, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.