Provider Demographics
NPI:1215094966
Name:SEAY, DONDRAIE LALETA (BACHELOR)
Entity type:Individual
Prefix:MISS
First Name:DONDRAIE
Middle Name:LALETA
Last Name:SEAY
Suffix:
Gender:F
Credentials:BACHELOR
Other - Prefix:MISS
Other - First Name:DONDRAIE
Other - Middle Name:LALETA
Other - Last Name:SEAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BACHELOR'S
Mailing Address - Street 1:1409 S CLAY ST
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31643-3505
Mailing Address - Country:US
Mailing Address - Phone:229-560-4382
Mailing Address - Fax:866-484-8285
Practice Address - Street 1:1409 S CLAY ST
Practice Address - Street 2:
Practice Address - City:QUITMAN
Practice Address - State:GA
Practice Address - Zip Code:31643-3505
Practice Address - Country:US
Practice Address - Phone:229-560-4382
Practice Address - Fax:866-484-8285
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
GA4547171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator