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NPI Code Detail

MEDICARE: SELINA DAWN SILVER LAC, ATR-P

MEDICARE: SELINA DAWN SILVER LAC, ATR-P
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorLAC-23948AZ

General Provider Information

NPI Number : 1104772128
Entity Type Code : Individual
Provider Name (Legal Business Name) : SELINA DAWN SILVER LAC, ATR-P
Provider Business Mailing Address
First Line : 839 W CONGRESS ST
Second Line :
City : TUCSON
State : AZ
Zip : 85745-2819
Country : US
Telephone Number : 520-309-3322
Fax Number :
Provider Business Practice Location Address
First Line : 839 W CONGRESS ST
Second Line :
City : TUCSON
State : AZ
Zip : 85745-2819
Country : US
Telephone Number : 520-309-3322
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2026
Last Update Date : 03/10/2026

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Directions to “ SELINA DAWN SILVER LAC, ATR-P” Practice Location

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