Individual
MAMIE SELMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1019 BRASSIE AVE, FLOSSMOOR, IL 60422-1352
(708) 501-0861
Mailing address
1019 BRASSIE AVE, FLOSSMOOR, IL 60422-1352
(708) 501-0861
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
1062285
IL
Other
Enumeration date
01/21/2014
Last updated
01/21/2014
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