Basic Information
| Provider Information | |||||||||
| NPI: | 1568075240 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HINOJOS | ||||||||
| FirstName: | SELINA | ||||||||
| MiddleName: | |||||||||
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| Credential: | BS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2906 HIGHWAY AVE | ||||||||
| Address2: | |||||||||
| City: | HIGHLAND | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463221631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2195138311 | ||||||||
| FaxNumber: | 7084792112 | ||||||||
| Practice Location | |||||||||
| Address1: | 251 W 84TH DR | ||||||||
| Address2: | |||||||||
| City: | MERRILLVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 464106243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2192053463 | ||||||||
| FaxNumber: | 3175208200 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/24/2020 | ||||||||
| LastUpdateDate: | 02/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | RBT-19-77117 | IN | Y |
No ID Information.