Provider Demographics
NPI:1770811853
Name:SEIBEL, JEAN (BC-DMT 460, LCAT)
Entity type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:SEIBEL
Suffix:
Gender:F
Credentials:BC-DMT 460, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SCHRADE RD
Mailing Address - Street 2:
Mailing Address - City:BRIARCLIFF MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10510-1410
Mailing Address - Country:US
Mailing Address - Phone:914-557-7668
Mailing Address - Fax:
Practice Address - Street 1:111 SCHRADE RD
Practice Address - Street 2:
Practice Address - City:BRIARCLIFF MANOR
Practice Address - State:NY
Practice Address - Zip Code:10510-1410
Practice Address - Country:US
Practice Address - Phone:914-557-7668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-30
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000348225600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist