Individual
JACQUELINE ANN PROFFITT SEIDL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2201 BAUER DR, KAILUA, HI 96734-4814
(808) 638-2892
Mailing address
2201 BAUER DR, KAILUA, HI 96734-4814
(808) 638-2892
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119004197
VA
225X00000X
Occupational Therapist
4529-026
WI
225X00000X
Occupational Therapist
Primary
OT-725
HI
Other
Enumeration date
04/10/2008
Last updated
04/10/2008
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