| Doctor Name: | KELLY SELOVER |
| NPI Number: | 1124338223 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PCC-S, NCC, CDCA |
| License Number: | 0700326 |
| Business Practice Address: | 3055 Rodenbeck Dr Suite 4b Beavercreek, OH - 454322699 |
| Business Phone Number: | 9374262113 |
| Business Fax Number: | 9374262114 |
| Mailing Address: | 3055 Rodenbeck Dr, Suite 4b BEAVERCREEK |
| State: | OH |
| Postal Code: | 454322699 |
| Phone Number: | 9374262113 |
| Fax Number: | 9374262114 |
| NPI Enumeration Date: | 10/07/2010 |
| NPI Last Update Date: | 06/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 0700326 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |