Provider Demographics
NPI:1174756944
Name:SEAMON, MARY ELIZABETH (MS,OTR/L)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ELIZABETH
Last Name:SEAMON
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 SCHUYLKILL MANOR RD
Mailing Address - Street 2:
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-3862
Mailing Address - Country:US
Mailing Address - Phone:570-624-3228
Mailing Address - Fax:
Practice Address - Street 1:1000 SCHUYLKILL MANOR RD
Practice Address - Street 2:
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3862
Practice Address - Country:US
Practice Address - Phone:570-624-3228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008024225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist