Provider Demographics
NPI:1225596547
Name:SESSA, LIANA
Entity type:Individual
Prefix:
First Name:LIANA
Middle Name:
Last Name:SESSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461 NEW LONDON RD
Mailing Address - Street 2:
Mailing Address - City:LANDENBERG
Mailing Address - State:PA
Mailing Address - Zip Code:19350-1115
Mailing Address - Country:US
Mailing Address - Phone:610-563-8637
Mailing Address - Fax:
Practice Address - Street 1:1086 HIGHWAY 315 BLVD
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-7012
Practice Address - Country:US
Practice Address - Phone:570-846-1025
Practice Address - Fax:570-904-8571
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH005478103K00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-16-27193OtherBACB REGISTRATION NUMBER