Ezell, Edith Selden

Ezell, Edith Selden is an sole proprietor health care provider with primary practice located at 4 Jackson St Ne , Fort Walton Beach FL 32548-4925. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Ezell, Edith Selden can be contacted via phone (850) 862-7227.

Contact Information

Primary practice address
4 Jackson St Ne Fort Walton Beach FL 32548-4925
Fax:
Website:

Health care specialties

Profile Details

NPI number 1457435455
LBN Legal business name Ezell, Edith Selden
Credentials OTR/L
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 25th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457435455 NPPES
Florida Other OT10239 FLORIDA LICENSE (OT)

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