Provider Demographics
NPI:1750453932
Name:SELTZER, MINDELLE KAPLAN (MED, MS)
Entity Type:Individual
Prefix:MRS
First Name:MINDELLE
Middle Name:KAPLAN
Last Name:SELTZER
Suffix:
Gender:F
Credentials:MED, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 GAMECOCK AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-3369
Mailing Address - Country:US
Mailing Address - Phone:843-766-3166
Mailing Address - Fax:843-852-9080
Practice Address - Street 1:27 GAMECOCK AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-3369
Practice Address - Country:US
Practice Address - Phone:843-766-3166
Practice Address - Fax:843-852-9080
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1708101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional