Provider Demographics
NPI:1235792896
Name:POGANSKI, SERENA E (RBT)
Entity Type:Individual
Prefix:MRS
First Name:SERENA
Middle Name:E
Last Name:POGANSKI
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MISS
Other - First Name:SERENA
Other - Middle Name:
Other - Last Name:EMORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:325 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WORMLEYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17043-1104
Mailing Address - Country:US
Mailing Address - Phone:844-588-4222
Mailing Address - Fax:717-775-3443
Practice Address - Street 1:325 N 2ND ST
Practice Address - Street 2:
Practice Address - City:WORMLEYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17043-1104
Practice Address - Country:US
Practice Address - Phone:844-588-4222
Practice Address - Fax:717-775-3443
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
PA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician