Healthcare Provider Details

I. General information

NPI: 1811365166
Provider Name (Legal Business Name): REBECCA SEIPLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 04/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2932 S 3 BS AND K RD
GALENA OH
43021-8545
US

IV. Provider business mailing address

7100 GRAPHICS WAY
LEWIS CENTER OH
43035-1122
US

V. Phone/Fax

Practice location:
  • Phone: 614-975-7615
  • Fax:
Mailing address:
  • Phone: 740-428-0428
  • Fax: 740-909-4077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1600270
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: