Provider Demographics
NPI:1932322500
Name:SELTZER, SARA BETH (MS)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:BETH
Last Name:SELTZER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:BETH
Other - Last Name:EFFINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:122 LANGLEY ROAD NORTH
Mailing Address - Street 2:SUITE B
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060
Mailing Address - Country:US
Mailing Address - Phone:410-222-0100
Mailing Address - Fax:410-222-0116
Practice Address - Street 1:122 LANGLEY ROAD NORTH
Practice Address - Street 2:SUITE B
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060
Practice Address - Country:US
Practice Address - Phone:410-222-0100
Practice Address - Fax:410-222-0116
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDSC0586101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)