Healthcare Provider Details

I. General information

NPI: 1669461240
Provider Name (Legal Business Name): CAROLYN M. SEAMAN PH. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 03/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 BROAD ST
KINDERHOOK NY
12106-1700
US

IV. Provider business mailing address

PO BOX 773
KINDERHOOK NY
12106-0773
US

V. Phone/Fax

Practice location:
  • Phone: 518-758-9342
  • Fax: 518-758-8482
Mailing address:
  • Phone: 508-758-9342
  • Fax: 518-758-8482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number005456
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: