Provider Demographics
NPI:1487133682
Name:SELLERS, AUDREY KATE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:KATE
Last Name:SELLERS
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 CULLOM ST S APT D
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-6517
Mailing Address - Country:US
Mailing Address - Phone:334-399-2291
Mailing Address - Fax:
Practice Address - Street 1:7054 VETERANS PKWY
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-5117
Practice Address - Country:US
Practice Address - Phone:205-227-7985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4684225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist