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Individual

JULIA SELBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MBS, LPC, LADC

Contact information

Practice address
4216 COMMERCIAL LN, DURANT, OK 74701-7785
(405) 360-2133
Mailing address
204 N BROADWAY ST, TISHOMINGO, OK 73460-1712

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
165
OK
101YP2500X
Professional Counselor
Primary
2796
OK

Other

Enumeration date
10/01/2009
Last updated
10/01/2009
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