Healthcare Provider Details

I. General information

NPI: 1285336669
Provider Name (Legal Business Name): MS. DELONA SESERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 FOUNTAINVIEW CIR APT 310
NEWARK DE
19713-3877
US

IV. Provider business mailing address

7108 S KANNER HWY
STUART FL
34997-7462
US

V. Phone/Fax

Practice location:
  • Phone: 973-670-5197
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number1761271
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: