MEDICARE: JUSTIN SEAMON BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1528944071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN SEAMON BCBA

Provider Business Mailing Address
First Line	:	7206 TABOR AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19111-4013
Country	:	US
Telephone Number	:	267-423-7894
Fax Number	:

Provider Business Practice Location Address
First Line	:	7206 TABOR AVE
Second Line	:
City	:	PHILA
State	:	PA
Zip	:	19111-4013
Country	:	US
Telephone Number	:	267-423-7894
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2025
Last Update Date	:	08/12/2025

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Directions to “ JUSTIN SEAMON BCBA” Practice Location

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