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Individual

CELINA CANADA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, BC, LBS

Contact information

Practice address
7020 N BROAD ST APT C9, PHILADELPHIA, PA 19126-1719
(267) 428-1202
Mailing address
7020 N BROAD ST APT C9, PHILADELPHIA, PA 19126-1719

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1982239984
CHIP
PA
01
BH004705
BEHAVIOR SPECIALIST
PA
Enumeration date
03/10/2020
Last updated
10/12/2023
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