MEDICARE: LINDA SELLERS

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1174932040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDA SELLERS

Provider Business Mailing Address
First Line	:	4930 ATHENS BAY PL
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-0970
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4930 ATHENS BAY PL
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-0970
Country	:	US
Telephone Number	:	702-539-7911
Fax Number	:

Authorized Official
Title or Position	:	HEALT PROFESSIAL
Name	:	LINDA SELLER
Credential	:
Telephone Number	:	702-539-7911

Provider Enumeration Date	:	08/05/2014
Last Update Date	:	08/05/2014

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Directions to “LINDA SELLERS ” Practice Location

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