Provider Demographics
NPI:1487037446
Name:SEIDEL, MAURA
Entity Type:Individual
Prefix:
First Name:MAURA
Middle Name:
Last Name:SEIDEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:392 S EMERSON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-2214
Mailing Address - Country:US
Mailing Address - Phone:720-272-1289
Mailing Address - Fax:
Practice Address - Street 1:392 S EMERSON ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2214
Practice Address - Country:US
Practice Address - Phone:720-272-1289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst