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NPI Code Detail

MEDICARE: CAROLINE PASSALINO

MEDICARE: CAROLINE PASSALINO
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
1103K00000XBehavior Analyst
2106S00000XBehavior Technician
3103K00000XBehavior Analyst12153242IL

General Provider Information

NPI Number : 1740803352
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLINE PASSALINO
Provider Business Mailing Address
First Line : 1219 SKYLARK DR
Second Line :
City : WESTON
State : FL
Zip : 33327-2380
Country : US
Telephone Number : 540-922-1110
Fax Number :
Provider Business Practice Location Address
First Line : 4908 N ELSTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60630-2506
Country : US
Telephone Number : 773-205-8505
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2020
Last Update Date : 01/02/2024

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Directions to “ CAROLINE PASSALINO ” Practice Location

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