Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 05-8E | AR |
N | 103TC1900X | Counseling Psychologist | KY-0571 | KY |
NPI | 1043279961 |
---|---|
Provider Name | Teresa L Seitz |
First Address | El Dorado, AR 71730-4403 |
Second Address | El Dorado, AR 71730-4403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 08/07/2007 |