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General NPI Number Information
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NPI Number | 1629951827
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Entity Type | Individual
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Provider Name | SELINA LORRAINE GRAHAM-MOLINE OTR-L, OTD
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Gender | Female
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 1295 KINWEST PKWY
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City | IRVING
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State | TX
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Zip | 75063-3560
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Country | US
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Telephone | 954-304-1887
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Fax |
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Provider Business Mailing Address
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Address Line | 4010 FAIRMONT LN
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City | HEARTLAND
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State | TX
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Zip | 75126-2539
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Country | US
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Telephone | 469-351-2280
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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 | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number | 122691
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License Number State | TX
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