Provider Demographics
NPI:1104070754
Name:GILLEECE, SEANEEN G (OTR)
Entity type:Individual
Prefix:MRS
First Name:SEANEEN
Middle Name:G
Last Name:GILLEECE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LESLIE CT
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-5524
Mailing Address - Country:US
Mailing Address - Phone:518-222-4172
Mailing Address - Fax:
Practice Address - Street 1:9 LESLIE CT
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-5524
Practice Address - Country:US
Practice Address - Phone:518-222-4172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4735-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist