Provider Demographics
NPI:1295711406
Name:SEHER, MARIZITA T (PSYD)
Entity type:Individual
Prefix:
First Name:MARIZITA
Middle Name:T
Last Name:SEHER
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 1:8 ROBERTS AVE
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-1320
Mailing Address - Country:US
Mailing Address - Phone:856-429-8463
Mailing Address - Fax:609-261-7199
Practice Address - Street 1:92 BRICK RD
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-2177
Practice Address - Country:US
Practice Address - Phone:856-429-8463
Practice Address - Fax:609-261-7199
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-20
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00430000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJQ38159Medicare UPIN