Provider Demographics
NPI:1336739358
Name:DREES, SELENA
Entity Type:Individual
Prefix:
First Name:SELENA
Middle Name:
Last Name:DREES
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 1:4750 COLLEGE ACRES DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-1724
Mailing Address - Country:US
Mailing Address - Phone:336-207-4747
Mailing Address - Fax:
Practice Address - Street 1:705 S KERR AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-8425
Practice Address - Country:US
Practice Address - Phone:919-743-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-23
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician