Healthcare Provider Details

I. General information

NPI: 1245545250
Provider Name (Legal Business Name): MARGARETTE ANNE SELLARS M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2010
Last Update Date: 08/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N 19TH ST
VAN BUREN AR
72956-4617
US

IV. Provider business mailing address

514 CRYSTAL VW
VAN BUREN AR
72956-9056
US

V. Phone/Fax

Practice location:
  • Phone: 479-474-2661
  • Fax:
Mailing address:
  • Phone: 479-414-8912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: