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General NPI Number Information
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NPI Number | 1639221310
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Entity Type | Individual
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Provider Name | SELINA SANCHEZ PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 08/24/2010
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Provider Practice Location Address
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Address Line | 10 WESTOWNE ST OFC PARK BUILDING 10
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City | LIBERTY
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State | MO
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Zip | 64068-1166
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Country | US
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Telephone | 816-518-0462
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Fax | 816-407-7706
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Provider Business Mailing Address
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Address Line | 10 WESTOWNE ST OFC PARK BUILDING 10
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City | LIBERTY
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State | MO
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Zip | 64068-1166
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Country | US
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Telephone | 816-518-0462
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Fax | 816-407-7706
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2002030471
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License Number State | MO
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