Individual
MARCIEL MARY SELBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.R
Contact information
Practice address
W7195 TERRITORIAL RD, ELKHORN, WI 53121-2858
(262) 495-2640
Mailing address
W7195 TERRITORIAL RD, ELKHORN, WI 53121-2858
(262) 495-2640
Taxonomy
Speciality
Code
Description
License number
State
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor
—
—
225CA2500X
Assistive Technology Supplier Rehabilitation Counselor
—
—
225CX0006X
Orientation and Mobility Training Rehabilitation Counselor
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40775300
—
WI
Enumeration date
02/06/2007
Last updated
09/11/2025
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