MEDICARE: MRS. KELLY ANN SEBREE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW5426	FL

General Provider Information

NPI Number	:	1841478211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELLY ANN SEBREE LCSW

Provider Business Mailing Address
First Line	:	723 IBIS WAY
Second Line	:
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-4705
Country	:	US
Telephone Number	:	561-624-2744
Fax Number	:

Provider Business Practice Location Address
First Line	:	PSC 1012 BOX 133
Second Line	:
City	:	FPO
State	:	AA
Zip	:	34058
Country	:	BS
Telephone Number	:	242-368-2007
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2008
Last Update Date	:	02/07/2008

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