Organization
SELENA ROE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SELENA ROE, JORDAN BCBA (BEHAVIOR ANALYST/ OWNER)
(727) 327-2457
Entity
Organization
Contact information
Practice address
2545 NE COACHMAN RD APT 150, CLEARWATER, FL 33765-1810
(727) 687-9261
Mailing address
2600 MARTIN LUTHER KING ST N STE 401, ST PETERSBURG, FL 33704-2744
(727) 327-2457
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BACB268792
FL
Other
Enumeration date
01/30/2017
Last updated
02/01/2017
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