Provider Demographics
NPI:1992134233
Name:SELIGMAN, LAURA DIANE (PHD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:DIANE
Last Name:SELIGMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:DIANE
Other - Last Name:HOVEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:3409 N HOLLAND SYLVANIA RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-1411
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3409 N HOLLAND SYLVANIA RD
Practice Address - Street 2:SUITE 8
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1411
Practice Address - Country:US
Practice Address - Phone:567-343-2989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5839103TB0200X, 103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent