Individual
SARAH ELLENWINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2753 S 11TH ST, NILES, MI 49120-4419
(269) 359-0689
(574) 204-2868
Mailing address
1824 TOUBY PIKE STE B, KOKOMO, IN 46901-2573
(765) 628-7400
(855) 940-0177
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
10/12/2021
Last updated
10/12/2021
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