Provider Demographics
NPI:1710305404
Name:DEGEARE, MORAYA SEEGER (LAMFT)
Entity Type:Individual
Prefix:
First Name:MORAYA
Middle Name:SEEGER
Last Name:DEGEARE
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:MORAYA
Other - Middle Name:SEEGER
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:594 WILLOUGHBY WAY W
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-5351
Mailing Address - Country:US
Mailing Address - Phone:845-235-5686
Mailing Address - Fax:
Practice Address - Street 1:594 WILLOUGHBY WAY W
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-5351
Practice Address - Country:US
Practice Address - Phone:845-235-5686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2891106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist