Individual
AMANDA NICOLE COLLEY SELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
758 ROYAL ST, BATON ROUGE, LA 70802-6433
(225) 529-3890
Mailing address
616 LAKE SHELF DR, BATON ROUGE, LA 70820-4568
(985) 212-9228
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
012077697
LA
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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