Doctor Name: | JOHANNA M SELISKAR |
NPI Number: | 1700867181 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LISW |
License Number: | I05628 |
Business Practice Address: | 3687 Veterans Dr Fort Harrison, MT - 596369703 |
Business Phone Number: | 4064476072 |
Business Fax Number: | 4064476030 |
Mailing Address: | 11 Pine View Dr, HELENA |
State: | MT |
Postal Code: | 596015534 |
Phone Number: | 4062020608 |
Fax Number: | |
NPI Enumeration Date: | 11/11/2005 |
NPI Last Update Date: | 05/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | I05628 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |