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General NPI Number Information
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NPI Number | 1073423042
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Entity Type | Individual
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Provider Name | SELINA NICOLE WHITESIDES RBT
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Gender | Female
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Dates
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Enumeration Date | 09/10/2026
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Last Update Date | 09/10/2026
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Provider Practice Location Address
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Address Line | 6312 S FIDDLERS GREEN CIR STE 300E
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-4831
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Country | US
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Telephone | 385-406-2590
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Fax | 385-494-3503
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Provider Business Mailing Address
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Address Line | 12275 CLAUDE CT
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City | NORTHGLENN
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State | CO
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Zip | 80241-3353
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Country | US
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Telephone | 702-445-0909
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | CO
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