Individual
SELENA BLUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 W COVINGTON AVE, OPP, AL 36467-2032
(334) 477-4686
Mailing address
181 W REYNOLDS ST, OZARK, AL 36360-1438
(334) 477-4686
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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