Provider Demographics
NPI:1679890156
Name:SEQUEIRA, DELIA (MS)
Entity type:Individual
Prefix:MS
First Name:DELIA
Middle Name:
Last Name:SEQUEIRA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31A GARFIELD PARK
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2522
Mailing Address - Country:US
Mailing Address - Phone:305-409-4242
Mailing Address - Fax:
Practice Address - Street 1:31A GARFIELD PARK
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2522
Practice Address - Country:US
Practice Address - Phone:305-409-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst