Basic Information
| Provider Information | |||||||||
| NPI: | 1568770956 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEAGAL | ||||||||
| FirstName: | EVE | ||||||||
| MiddleName: | MARLA | ||||||||
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| Credential: | MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 S. FARRELL DRIVE | ||||||||
| Address2: | |||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92262 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7604161360 | ||||||||
| FaxNumber: | 7604161362 | ||||||||
| Practice Location | |||||||||
| Address1: | 3360 HWY 411 N | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4238875131 | ||||||||
| FaxNumber: | 4238875917 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2010 | ||||||||
| LastUpdateDate: | 02/07/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/07/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YS0200X | TN | Y | Behavioral Health & Social Service Providers | Counselor | School |
No ID Information.