MEDICARE: MRS. CHRISTINE MARIE SEDA M.A,BEHAVIOR ANALYST

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	101YM0800X	Mental Health Counselor	004859	PR
2	222Q00000X	Developmental Therapist
3	2355S0801X	Speech-Language Assistant
4	103K00000X	Behavior Analyst	12153588	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902231715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTINE MARIE SEDA M.A,BEHAVIOR ANALYST

Provider Business Mailing Address
First Line	:	476 CARDINAL CT
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34759-4423
Country	:	US
Telephone Number	:	407-785-8196
Fax Number	:

Provider Business Practice Location Address
First Line	:	2897 PICADILLY CIR
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34747-1638
Country	:	US
Telephone Number	:	407-785-8196
Fax Number	:

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

Provider Enumeration Date	:	09/11/2013
Last Update Date	:	10/04/2021

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