Individual
AUDREY SELPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MT-BC
Contact information
Practice address
1825 BATH AVE, BROOKLYN, NY 11214-4613
(718) 238-4637
Mailing address
3944 51ST ST, 1F, WOODSIDE, NY 11377-3149
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
09539
—
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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