Provider Demographics
NPI:1396301883
Name:VON SEELEN, MORGAN LEIGH (OTR/L, MOT)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:LEIGH
Last Name:VON SEELEN
Suffix:
Gender:F
Credentials:OTR/L, MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5915 BROUK VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:63051-1508
Mailing Address - Country:US
Mailing Address - Phone:636-209-1611
Mailing Address - Fax:
Practice Address - Street 1:5915 BROUK VALLEY DR
Practice Address - Street 2:
Practice Address - City:HOUSE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:63051-1508
Practice Address - Country:US
Practice Address - Phone:636-209-1611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016024906225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist