Provider Demographics
NPI:1164788543
Name:SELMAN, ASHLEY M
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:SELMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6435 GRASS MEADOWS DR
Mailing Address - Street 2:#115
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89142-2874
Mailing Address - Country:US
Mailing Address - Phone:702-299-5695
Mailing Address - Fax:
Practice Address - Street 1:6435 GRASS MEADOWS DR
Practice Address - Street 2:#115
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89142-2874
Practice Address - Country:US
Practice Address - Phone:702-299-5695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner