Provider Demographics
NPI:1013418128
Name:SEEBER, DENISE ILEEN
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:ILEEN
Last Name:SEEBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:ILEEN
Other - Last Name:CONARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:607 DEWEY AVE NW STE 300
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-7335
Mailing Address - Country:US
Mailing Address - Phone:616-356-5000
Mailing Address - Fax:616-356-5001
Practice Address - Street 1:3265 122ND AVE
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-9511
Practice Address - Country:US
Practice Address - Phone:269-673-2102
Practice Address - Fax:269-686-4683
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201002226225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist