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Provider Information for 1639356694


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MILDRED ALICE SELLARS LCSW


Sex: Female

NPI: 1639356694
Last Updated: 2008-01-22
Certification Date:

Details

NameValue
NPI1639356694
Enumeration Date2008-01-22
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 1800 MERCY DR
SUITE 302
ORLANDO, FL 32808-5646
United States

Phone: 407-875-3700 | Fax:407-522-4671
 
Primary Practice Address 1800 MERCY DR
SUITE 302
ORLANDO, FL 32808-5646
United States

Phone: 407-875-3700 | Fax:407-522-4671
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Other (non-Medicare)FLSW 7914LCSW
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalFLSW 7914