Provider Demographics
NPI:1629951827
Name:GRAHAM-MOLINE, SELINA LORRAINE (OTD, OTR-L)
Entity type:Individual
Prefix:DR
First Name:SELINA
Middle Name:LORRAINE
Last Name:GRAHAM-MOLINE
Suffix:
Gender:F
Credentials:OTD, OTR-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 FAIRMONT LN
Mailing Address - Street 2:
Mailing Address - City:HEARTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75126-2539
Mailing Address - Country:US
Mailing Address - Phone:954-304-1887
Mailing Address - Fax:
Practice Address - Street 1:1295 KINWEST PKWY
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3560
Practice Address - Country:US
Practice Address - Phone:954-304-1887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122691225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontologyGroup - Single Specialty