Provider Demographics
NPI:1235758921
Name:SELLERS, EMILY ANNE (AMFT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE
Last Name:SELLERS
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4156 N FREMONT DR
Mailing Address - Street 2:
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-4941
Mailing Address - Country:US
Mailing Address - Phone:801-837-9798
Mailing Address - Fax:
Practice Address - Street 1:12401 S 450 E UNIT D2A
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7938
Practice Address - Country:US
Practice Address - Phone:801-277-6851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-13
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12285749-3904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist