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General NPI Number Information
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NPI Number | 1538730643
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Entity Type | Individual
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Provider Name | MICAELA MARIE SERAFINI
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Gender | Female
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Dates
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Enumeration Date | 07/08/2021
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Last Update Date | 07/08/2021
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Provider Practice Location Address
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Address Line | 707 LAKE COOK RD STE 314
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City | DEERFIELD
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State | IL
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Zip | 60015-4933
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Country | US
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Telephone | 888-981-7789
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Fax |
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Provider Business Mailing Address
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Address Line | 950 LEE ST STE 210
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City | DES PLAINES
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State | IL
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Zip | 60016-6574
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Country | US
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Telephone |
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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 | RBT-21-158316
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License Number State | IL
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