Provider Demographics
NPI:1942094305
Name:ITURBE, SELENA
Entity type:Individual
Prefix:
First Name:SELENA
Middle Name:
Last Name:ITURBE
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 1:5151 HEADQUARTERS DR STE 240
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-0021
Mailing Address - Country:US
Mailing Address - Phone:469-214-5116
Mailing Address - Fax:
Practice Address - Street 1:5151 HEADQUARTERS DR STE 240
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-0021
Practice Address - Country:US
Practice Address - Phone:469-214-5116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TX99080101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program