Provider Demographics
NPI:1477068518
Name:SELLERS, SHANTE ALEAH (MSCCC-SLP)
Entity type:Individual
Prefix:
First Name:SHANTE
Middle Name:ALEAH
Last Name:SELLERS
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:MISS
Other - First Name:SHANTE
Other - Middle Name:ALEAH
Other - Last Name:SELLERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS,CCC-SLP
Mailing Address - Street 1:7799 STYLES BLVD # 210
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34747-1657
Mailing Address - Country:US
Mailing Address - Phone:407-968-1754
Mailing Address - Fax:
Practice Address - Street 1:7799 STYLES BLVD
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34747-1657
Practice Address - Country:US
Practice Address - Phone:321-241-6093
Practice Address - Fax:321-241-4400
Is Sole Proprietor?:No
Enumeration Date:2017-12-12
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA16516235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist