Provider Demographics
NPI:1083457824
Name:SILVAS, SELINA
Entity type:Individual
Prefix:
First Name:SELINA
Middle Name:
Last Name:SILVAS
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 1:14780 W VAN BUREN ST APT 3001
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-4764
Mailing Address - Country:US
Mailing Address - Phone:480-519-9441
Mailing Address - Fax:
Practice Address - Street 1:14780 W VAN BUREN ST APT 3001
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-4764
Practice Address - Country:US
Practice Address - Phone:480-519-9441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA152922355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant