Provider Demographics
NPI:1902201304
Name:SELLI, MARILIA (MFT)
Entity Type:Individual
Prefix:
First Name:MARILIA
Middle Name:
Last Name:SELLI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54-249A ANOILEI PL
Mailing Address - Street 2:
Mailing Address - City:HAUULA
Mailing Address - State:HI
Mailing Address - Zip Code:96717-9621
Mailing Address - Country:US
Mailing Address - Phone:808-741-6220
Mailing Address - Fax:
Practice Address - Street 1:1500 S BERETANIA STREET
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1102
Practice Address - Country:US
Practice Address - Phone:808-945-3690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist