Individual
MARY SELKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
(541) 492-0191
(541) 672-1688
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 492-0191
(541) 672-1688
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14-11-10
OR
Other
Enumeration date
09/23/2015
Last updated
06/16/2021
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