Provider Demographics
NPI:1821316829
Name:SELLMAN, HEATHER ANNE (MS,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ANNE
Last Name:SELLMAN
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:ANNE
Other - Last Name:GNESA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CCC-SLP
Mailing Address - Street 1:3220 COHO DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-7903
Mailing Address - Country:US
Mailing Address - Phone:209-505-0867
Mailing Address - Fax:
Practice Address - Street 1:3220 COHO DR
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-7903
Practice Address - Country:US
Practice Address - Phone:209-505-0867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2013-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18038235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist