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General NPI Number Information
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NPI Number | 1104470830
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Entity Type | Individual
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Provider Name | JESSICA LYNN LOPEZ SEELY OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/31/2019
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 1239 N COUNTRY RD STE 4
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City | STONY BROOK
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State | NY
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Zip | 11790-1920
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Country | US
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Telephone | 631-371-3178
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Fax |
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Provider Business Mailing Address
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Address Line | 10 CAMELOT LN
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City | EAST SETAUKET
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State | NY
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Zip | 11733-1707
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Country | US
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Telephone | 631-371-3178
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 027256
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 21512
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 027256
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | 027256
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License Number State | NY
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