Provider Demographics
NPI:1083468151
Name:SEABRUN, KEAUNNA JONISE (MFT)
Entity Type:Individual
Prefix:
First Name:KEAUNNA
Middle Name:JONISE
Last Name:SEABRUN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 WALTON RESERVE BLVD APT 9306
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30168-2533
Mailing Address - Country:US
Mailing Address - Phone:404-754-1700
Mailing Address - Fax:
Practice Address - Street 1:1500 WALTON RESERVE BLVD APT 9306
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30168-2533
Practice Address - Country:US
Practice Address - Phone:404-754-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist