Organization
THE CENTER FOR BODY ORIENTED PSYCHOTHERAPY & WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD A. SELCKE M.F.T. (FOUNDER, CLINICAL DIRECTOR)
(707) 595-5637
Entity
Organization
Contact information
Practice address
1626 FOURTH STREET, SANTA ROSA, CA 95404
(707) 595-5637
(707) 595-5637
Mailing address
1626 FOURTH STREET, SANTA ROSA, CA 95404
(707) 595-5637
(707) 595-5637
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
106H00000X
Marriage & Family Therapist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/12/2015
Last updated
01/12/2015
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