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General NPI Number Information
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NPI Number | 1659643310
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Entity Type | Individual
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Provider Name | JADE LEE-ANN SEIBERT L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 01/27/2012
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Last Update Date | 01/27/2012
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Provider Practice Location Address
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Address Line | 25022 US HIGHWAY 19 N
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City | CLEARWATER
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State | FL
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Zip | 33763-3918
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Country | US
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Telephone | 727-216-3997
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Fax |
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Provider Business Mailing Address
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Address Line | 485 PAULA DR S APT. B
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City | DUNEDIN
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State | FL
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Zip | 34698-2066
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Country | US
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Telephone | 727-324-7663
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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 | 163WM1400X
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Taxonomy Name | Nurse Massage Therapist (NMT)
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License Number | MA56490
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License Number State | FL
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