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Individual

MS. AVA ELIZABETH SELKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, TLLP

Contact information

Practice address
6549 TOWN CENTER DR STE A, CLARKSTON, MI 48346-4824
(248) 620-6400
Mailing address
6549 TOWN CENTER DR STE A, CLARKSTON, MI 48346-4824
(248) 620-6400

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
6301018366
MI
103TC0700X
Clinical Psychologist
Primary
6362001113
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
106S00000X
TAXONOMY
MI
Enumeration date
05/16/2018
Last updated
04/30/2020
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