Provider Demographics
NPI:1821863077
Name:SELBST, TAYLOR ASHLEY (OTR)
Entity Type:Individual
Prefix:
First Name:TAYLOR
Middle Name:ASHLEY
Last Name:SELBST
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-9409
Mailing Address - Country:US
Mailing Address - Phone:215-817-3933
Mailing Address - Fax:
Practice Address - Street 1:4 ESTATES DR
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-9409
Practice Address - Country:US
Practice Address - Phone:215-817-3933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01151700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist