Healthcare Provider Details

I. General information

NPI: 1457906265
Provider Name (Legal Business Name): SALENA BEQUETTE BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2019
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 S DOUGLAS RD STE 203
CORAL GABLES FL
33134-4108
US

IV. Provider business mailing address

1921 W IRVING PARK RD
CHICAGO IL
60613-2407
US

V. Phone/Fax

Practice location:
  • Phone: 844-244-1818
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-75400
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: