Provider Demographics
NPI:1346663366
Name:SELENT, HONOUR
Entity Type:Individual
Prefix:
First Name:HONOUR
Middle Name:
Last Name:SELENT
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 1:500 E UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-7206
Mailing Address - Country:US
Mailing Address - Phone:248-608-1386
Mailing Address - Fax:248-608-1399
Practice Address - Street 1:500 E UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-7206
Practice Address - Country:US
Practice Address - Phone:248-608-1386
Practice Address - Fax:248-608-1399
Is Sole Proprietor?:No
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2538121225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant