Individual
JOHN SELTENREICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
21 BROADLEAF DR, CLIFTON PARK, NY 12065-5719
(518) 859-3951
(518) 373-5925
Mailing address
21 BROADLEAF DR, CLIFTON PARK, NY 12065-5719
(518) 859-3951
(518) 373-5925
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
010817-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010817-1
LICENSE REGISTRATION CERT
NY
05
—
01939528
—
NY
Enumeration date
06/06/2006
Last updated
07/09/2007
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