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NPI 1679416119

NPI 1679416119 : EMMA GABRIELLE SELLORS : KING GEORGE, VA

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General NPI Number Information
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    NPI Number           |    1679416119
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    Entity Type          |    Individual 
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    Provider Name        |    EMMA GABRIELLE SELLORS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/10/2026
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    Last Update Date     |    04/10/2026
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Provider Practice Location Address
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    Address Line         |    5219 KINGS WOOD LN 
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    City                 |    KING GEORGE
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    State                |    VA
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    Zip                  |    22485-5612
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    Country              |    US
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    Telephone            |    540-750-4499
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1701 ASHFORD CIR APT 116 
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    City                 |    FREDERICKSBURG
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    State                |    VA
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    Zip                  |    22401-5072
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    Country              |    US
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    Telephone            |    804-296-8931
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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