Basic Information
| Provider Information | |||||||||
| NPI: | 1417538968 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEEDNER | ||||||||
| FirstName: | ANGELIQUE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 BRIDGEVIEW TERRRACE | ||||||||
| Address2: | APT 2 | ||||||||
| City: | KITTERY | ||||||||
| State: | ME | ||||||||
| PostalCode: | 03904 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 22 TUCK RD | ||||||||
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| City: | HAMPTON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 038421225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6039264551 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2021 | ||||||||
| LastUpdateDate: | 04/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 0840 | NH | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.