Provider Demographics
NPI:1255128310
Name:SEETON, JENNA GRACE (OTR)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:GRACE
Last Name:SEETON
Suffix:
Gender:
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 PRICKETT LN
Mailing Address - Street 2:
Mailing Address - City:HAINESPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08036-4875
Mailing Address - Country:US
Mailing Address - Phone:609-850-1397
Mailing Address - Fax:
Practice Address - Street 1:200 SCOTT AVE
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-7760
Practice Address - Country:US
Practice Address - Phone:443-572-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01231800225X00000X
MD10488225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist