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Individual

MS. JACLYN SELWYN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5071 NW 125TH AVE, CORAL SPRINGS, FL 33076-3448
(954) 899-6655
Mailing address
5071 NW 125TH AVE, CORAL SPRINGS, FL 33076-3448

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT9750
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
887644400
FL
Enumeration date
10/26/2006
Last updated
01/25/2010
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