MEDICARE: SATORI ELIZABETH KEARNEY BCBA

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	0-12-4397	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609116888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SATORI ELIZABETH KEARNEY BCBA

Provider Business Mailing Address
First Line	:	235 3RD AVE N UNIT 406
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33701-3378
Country	:	US
Telephone Number	:	727-742-8697
Fax Number	:	800-981-5129

Provider Business Practice Location Address
First Line	:	235 3RD AVE N UNIT 406
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33701-3378
Country	:	US
Telephone Number	:	727-742-8697
Fax Number	:	800-981-5129

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

Provider Enumeration Date	:	02/25/2013
Last Update Date	:	06/15/2021

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