Provider Demographics
NPI:1073758587
Name:SELANDER, CAROL LOU (MS)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:LOU
Last Name:SELANDER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 S COLORADO BLVD
Mailing Address - Street 2:SUITE 410
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3648
Mailing Address - Country:US
Mailing Address - Phone:303-321-1113
Mailing Address - Fax:303-321-1113
Practice Address - Street 1:1400 S COLORADO BLVD
Practice Address - Street 2:SUITE 410
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3648
Practice Address - Country:US
Practice Address - Phone:303-321-1113
Practice Address - Fax:303-321-1113
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1755101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health