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General NPI Number Information
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NPI Number | 1366634842
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Entity Type | Individual
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Provider Name | MARNIE SELSTEDT
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Gender | Female
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 08/17/2007
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Provider Practice Location Address
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Address Line | 3715 SW 29TH ST
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City | TOPEKA
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State | KS
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Zip | 66614-2107
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Country | US
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Telephone | 785-272-1535
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Fax |
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Provider Business Mailing Address
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Address Line | 12114 CORNELISON CIR
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City | WICHITA
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State | KS
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Zip | 67235-1524
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Country | US
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Telephone |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 18-00513
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License Number State | KS
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