Provider Demographics
NPI:1902797954
Name:SEIDEL, AMANDA (LMT, BCTMB)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:SEIDEL
Suffix:
Gender:F
Credentials:LMT, BCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2081 MUNDEN POINT RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23457-1248
Mailing Address - Country:US
Mailing Address - Phone:856-993-0244
Mailing Address - Fax:
Practice Address - Street 1:2401 SEABOARD RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-3500
Practice Address - Country:US
Practice Address - Phone:856-993-0244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019010330225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist