Provider Demographics
NPI:1225384068
Name:SELMAN, ALEXANDRA EVE
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRA
Middle Name:EVE
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 1:175 OCEAN ST
Mailing Address - Street 2:#38
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-3125
Mailing Address - Country:US
Mailing Address - Phone:617-960-6780
Mailing Address - Fax:
Practice Address - Street 1:112 MARKET ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1125
Practice Address - Country:US
Practice Address - Phone:781-592-5691
Practice Address - Fax:781-595-4393
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor