| NPI | 1396039079 |
|---|---|
| Former Name | BRIDGET RANEE SELBY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 5161) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK TEMP) |
| Enumeration Date | 2011-05-31 |
| Last Update Date | 2013-10-04 |