Doctor Name: | JOHN W SELDEN |
NPI Number: | 1225139611 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD LP |
License Number: | LP0313 |
Business Practice Address: | 3203 W 3rd Ave Range Mental Health Center Inc Perpich Building Hibbing, MN - 55746 |
Business Phone Number: | 2182639237 |
Business Fax Number: | 2182623150 |
Mailing Address: | 3203 W 3rd Ave, Range Mental Health Center Inc Perpich Building HIBBING |
State: | MN |
Postal Code: | 55746 |
Phone Number: | 2182639237 |
Fax Number: | 2182623150 |
NPI Enumeration Date: | 09/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | LP0313 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |