Basic Information
| Provider Information | |||||||||
| NPI: | 1558700872 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SEEL | ||||||||
| FirstName: | MAGGIE | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | OTR/L | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WOLENTER | ||||||||
| OtherFirstName: | MAGGIE | ||||||||
| OtherMiddleName: | ANN | ||||||||
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| OtherCredential: | OTR/L | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 220 S LECATO AVE | ||||||||
| Address2: | |||||||||
| City: | AUDUBON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 081061134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6095045704 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1020 PITNEY RD | ||||||||
| Address2: | |||||||||
| City: | ABSECON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 082019716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6096465400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2013 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT.0003587 | CO | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | OC012476 | PA | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 225X00000X | 46TR00816600 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.