Provider Demographics
NPI:1053793547
Name:SELDON, MARSHA
Entity type:Individual
Prefix:MRS
First Name:MARSHA
Middle Name:
Last Name:SELDON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 DEWEY ST
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093-2410
Mailing Address - Country:US
Mailing Address - Phone:478-960-8985
Mailing Address - Fax:
Practice Address - Street 1:103 DEWEY ST
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-2410
Practice Address - Country:US
Practice Address - Phone:478-960-8985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst