Provider Demographics
NPI:1538224506
Name:SEABURN, DAVID B (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:B
Last Name:SEABURN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BAUERS CV
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-1246
Mailing Address - Country:US
Mailing Address - Phone:585-349-5156
Mailing Address - Fax:585-349-5155
Practice Address - Street 1:71 LYELL AVE
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-1825
Practice Address - Country:US
Practice Address - Phone:585-349-5155
Practice Address - Fax:585-349-5155
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000276-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist