Provider Demographics
NPI:1891183364
Name:SEGUIN, JUDY LEANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:LEANNE
Last Name:SEGUIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19347 US HIGHWAY 19 N APT 111
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-3305
Mailing Address - Country:US
Mailing Address - Phone:970-657-0094
Mailing Address - Fax:
Practice Address - Street 1:19347 US HIGHWAY 19 N APT 111
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-3305
Practice Address - Country:US
Practice Address - Phone:970-657-0094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-06
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0003966103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical