Provider Demographics
NPI:1538516232
Name:MOSLEMI, SETAREH DEHGHANI (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:SETAREH
Middle Name:DEHGHANI
Last Name:MOSLEMI
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 LEEWARD PL
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6319
Mailing Address - Country:US
Mailing Address - Phone:408-666-7363
Mailing Address - Fax:
Practice Address - Street 1:2301 LEEWARD PL
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-6319
Practice Address - Country:US
Practice Address - Phone:408-666-7363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
11621912103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst