| NPI | 1396955365 |
|---|---|
| Former Name | CAROL LYNNE SELBST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: FL RN2205152) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-07-08 |