Individual
JUSTIN D SELDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9423 DORCHESTER DR, BATON ROUGE, LA 70814-2840
(225) 573-7899
Mailing address
9423 DORCHESTER DR, BATON ROUGE, LA 70814-2840
(225) 573-7899
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000
—
LA
Enumeration date
02/14/2018
Last updated
06/16/2018
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