Healthcare Provider Details

I. General information

NPI: 1952710758
Provider Name (Legal Business Name): HANNAH SEGER MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2014
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12010 ETRIS RD SUITE A-150
ROSWELL GA
30075-1421
US

IV. Provider business mailing address

1489 BROOKCLIFF DR
MARIETTA GA
30062-4837
US

V. Phone/Fax

Practice location:
  • Phone: 770-998-9599
  • Fax:
Mailing address:
  • Phone: 413-222-2756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number1839645
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: