Individual
SIDNEY NICOLE SELEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4601 EAGLERIDGE PL STE 140, PUEBLO, CO 81008-4101
(719) 253-7727
Mailing address
164 E PALMER LAKE DR, PUEBLO WEST, CO 81007-1741
(719) 569-0732
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.0001707
CO
Other
Enumeration date
07/20/2023
Last updated
07/20/2023
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