MEDICARE: CHRISTINA PAIGE SEIFRIED BCBA

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
1	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst	BACB605335	OR

General Provider Information

NPI Number	:	1073126686
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA PAIGE SEIFRIED BCBA

Provider Business Mailing Address
First Line	:	640 GRASSMERE PARK STE 116
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-3678
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	640 GRASSMERE PARK STE 116
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-3678
Country	:	US
Telephone Number	:	804-466-1323
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2020
Last Update Date	:	08/28/2023

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