Provider Demographics
NPI:1174932040
Name:LINDA SELLERS
Entity type:Organization
Organization Name:LINDA SELLERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALT PROFESSIAL
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-539-7911
Mailing Address - Street 1:4930 ATHENS BAY PL
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-0970
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4930 ATHENS BAY PL
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-0970
Practice Address - Country:US
Practice Address - Phone:702-539-7911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty