MEDICARE: DIANA SEJAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	S220172866070	FL

General Provider Information

NPI Number	:	1194278523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA SEJAS

Provider Business Mailing Address
First Line	:	101 CAMPHOR TREE LN
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-5802
Country	:	US
Telephone Number	:	407-408-5983
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 CAMPHOR TREE LN
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32714-5802
Country	:	US
Telephone Number	:	407-408-5983
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2016
Last Update Date	:	08/02/2016

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Directions to “ DIANA SEJAS ” Practice Location

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