Individual
SELINA LOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 S BLOUNT ST, MADISON, WI 53703-4664
(608) 405-5111
Mailing address
301 S BLOUNT ST, MADISON, WI 53703-4664
(608) 405-5111
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4987-226
WI
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/16/2019
Last updated
05/03/2022
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