Provider Demographics
NPI:1104977347
Name:SELIGSOHN, KAREN J (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:J
Last Name:SELIGSOHN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KAY
Other - Middle Name:J
Other - Last Name:SELIGSOHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:20 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-1104
Mailing Address - Country:US
Mailing Address - Phone:617-698-1778
Mailing Address - Fax:
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-5608
Practice Address - Fax:617-730-0252
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6831103G00000X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent