| NPI | 1083872683 |
|---|---|
| Former Name | BRETTA SELBY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 57537) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO 307) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2013-03-26 |