Selina Marie Reyna

Individual provider Active NPI Speech-Language Pathologist · Poteet, TX

NPI 1972156941 · NPPES record last updated Jul 18, 2019

Key facts

NPI
1972156941
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
32730 (TX)
Practice address
160 Broken Star TRL
Poteet, TX 78065-4343
Phone
(361) 227-9042
NPI assigned
Jul 18, 2019
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

LicenseStateTypeSpecialty
32730TXMDPsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 32730 TX Yes

Addresses

Primary practice location

160 Broken Star TRL
Poteet, TX 78065-4343

Mailing address

160 Broken Star TRL
Poteet, TX 78065-4343

Other practice location 1

160 Broken Star Trl
Poteet, TX 78065-4343

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL Agelesslivinghh.com

Other providers in Poteet, TX

All providers in Poteet, TX · Speech-Language Pathologist in Texas

Sources for this page

Verify at the official NPI Registry.