Provider Demographics
NPI:1205582657
Name:HARTZ, SEAN BAKER (BCBA, LBA NY)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:BAKER
Last Name:HARTZ
Suffix:
Gender:M
Credentials:BCBA, LBA NY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12302-4414
Mailing Address - Country:US
Mailing Address - Phone:518-424-7063
Mailing Address - Fax:
Practice Address - Street 1:30 ORCHARD DR
Practice Address - Street 2:
Practice Address - City:GLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12302-4414
Practice Address - Country:US
Practice Address - Phone:518-424-7063
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst