Healthcare Provider Details

I. General information

NPI: 1275359051
Provider Name (Legal Business Name): SELMA HUSKIC OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2024
Last Update Date: 11/26/2024
Certification Date: 11/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 S LOCUST ST
GRAND ISLAND NE
68801-6751
US

IV. Provider business mailing address

929 S LOCUST ST
GRAND ISLAND NE
68801-6751
US

V. Phone/Fax

Practice location:
  • Phone: 308-382-9700
  • Fax: 308-382-9898
Mailing address:
  • Phone: 308-382-9700
  • Fax: 308-382-9898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number2948
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: