Denise Marie Selph, LMT
Individual provider Active NPI Massage Therapist · Jasper, FL
NPI 1124339098 · NPPES record last updated Apr 22, 2024
Key facts
- NPI
- 1124339098
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- MA103045 (FL)
- Practice address
- 201 2ND Ave SE
Jasper, FL 32052-6111 - Phone
- (386) 792-1140
- NPI assigned
- Jun 25, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA103045 | FL | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MA103045 | FL | Yes |
Addresses
Primary practice location
201 2ND Ave SE
Jasper, FL 32052-6111
Mailing address
201 2ND Ave SE
Jasper, FL 32052-6111
Phone (386) 792-1140
Other providers in Jasper, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.