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Individual

MR. MARK W. SEYMOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.C.C.

Contact information

Practice address
710 CLEVELAND AVE, FREMONT, OH 43420-3224
(419) 334-6619
(419) 334-6663
Mailing address
1925 HAYES AVE, SANDUSKY, OH 44870-4737
(419) 557-5177
(419) 557-5179

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C0005669
OH
101YP2500X
Professional Counselor
Primary
E 0005669
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0156327
OH
Enumeration date
01/08/2010
Last updated
04/12/2024
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