Provider Demographics
NPI:1447573993
Name:SELBY, LARRAH LYNN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LARRAH
Middle Name:LYNN
Last Name:SELBY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 E. PECAN GROVE ROAD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-1767
Mailing Address - Country:US
Mailing Address - Phone:903-893-7768
Mailing Address - Fax:903-893-4979
Practice Address - Street 1:804 PECAN GROVE RD E
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-1767
Practice Address - Country:US
Practice Address - Phone:903-893-7768
Practice Address - Fax:903-893-4979
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62670101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional