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General NPI Number Information
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NPI Number | 1245565183
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Entity Type | Individual
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Provider Name | KATHLEEN THERESE SERAFIN M.ED., BCBA
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Gender | Female
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Dates
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Enumeration Date | 10/09/2009
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 18 N CATHERINE AVE
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City | LA GRANGE
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State | IL
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Zip | 60525-5930
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Country | US
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Telephone | 773-636-3865
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Fax |
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Provider Business Mailing Address
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Address Line | 12312 S 75TH AVE
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1306
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Country | US
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Telephone | 773-636-3865
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 152.000779
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 14-000-0000-00
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-13-14442
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License Number State | IL
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