Individual
TARA M SELBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
200 W 12TH ST, WAYNESBORO, VA 22980-4771
(540) 941-5501
Mailing address
1102 ROSE HILL DR, CHARLOTTESVILLE, VA 22903-5128
(434) 979-8628
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0119007600
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119007600
STATE LICENSE
VA
Enumeration date
02/15/2018
Last updated
12/12/2023
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