Doctor Name: | MR. LARAMIE C SELMAN |
NPI Number: | 1003183914 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 32049 |
Business Practice Address: | 4101 University Blvd Tyler, TX - 757016623 |
Business Phone Number: | 9033637704 |
Business Fax Number: | |
Mailing Address: | Po Box 883, FRANKSTON |
State: | TX |
Postal Code: | 757630883 |
Phone Number: | 9033637704 |
Fax Number: | |
NPI Enumeration Date: | 11/20/2011 |
NPI Last Update Date: | 11/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 32049 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |