Provider Information for 1841485968
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SELMA DIAN WESLEY LCSW
Sex: Female
NPI: 1841485968
Last Updated: 2007-09-11
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1841485968 | ||||||||
| Enumeration Date | 2007-09-11 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 3624 GORDON AVE SAINT LOUIS, MO 63114-4006 United States Phone: 314-423-2354 | Fax:314-423-2354 | ||||||||
| Primary Practice Address | 3624 GORDON AVE SAINT LOUIS, MO 63114-4006 United States Phone: 314-423-2354 | Fax:314-423-2354 | ||||||||
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