Provider Demographics
NPI:1891375929
Name:SELLERS, DIANA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:
Last Name:SELLERS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7423 DUTCH LOOP
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80925-9466
Mailing Address - Country:US
Mailing Address - Phone:919-609-5193
Mailing Address - Fax:
Practice Address - Street 1:265 S HARLAN ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-2261
Practice Address - Country:US
Practice Address - Phone:720-272-1289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No171M00000XOther Service ProvidersCase Manager/Care Coordinator