Basic Information
| Provider Information | |||||||||
| NPI: | 1003018318 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEYBERT | ||||||||
| FirstName: | AMBER | ||||||||
| MiddleName: | D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1123 ROCKDALE AVE | ||||||||
| Address2: | |||||||||
| City: | NEW BEDFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027402947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089977448 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1123 ROCKDALE AVE | ||||||||
| Address2: | |||||||||
| City: | NEW BEDFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027402947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089977448 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2007 | ||||||||
| LastUpdateDate: | 01/14/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 6680 | MA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | SA8276 | FL | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.