Individual
JEANNE C. SELBY
Active
Individual
JEANNE C. SELBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
31083
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0072PQ
BLUE CROSS BLUE SHIELD (BCBS)
—
05
—
157554007
—
TX
01
—
396566
MANAGED HEALTH NETWORK (MHN)
—
01
—
7192856
AETNA
—
Enumeration date
07/07/2006
Last updated
06/09/2008
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