Provider Demographics
NPI:1942405311
Name:SEYMOUR, MARLA HIGHFIELD (OTR)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:HIGHFIELD
Last Name:SEYMOUR
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 THORNY VINE CT
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-1641
Mailing Address - Country:US
Mailing Address - Phone:919-453-1606
Mailing Address - Fax:
Practice Address - Street 1:3509 HAWORTH DR
Practice Address - Street 2:SUITE 222
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7238
Practice Address - Country:US
Practice Address - Phone:919-662-8340
Practice Address - Fax:919-832-6405
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6172225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics