Provider Demographics
NPI:1003291048
Name:SALAZAR, PEGGY A
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:A
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:A,
Other - Last Name:SALAZAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LPCC
Mailing Address - Street 1:5650 GREENWOOD PLAZA BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2309
Mailing Address - Country:US
Mailing Address - Phone:303-503-0372
Mailing Address - Fax:
Practice Address - Street 1:5650 GREENWOOD PLAZA BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2307
Practice Address - Country:US
Practice Address - Phone:303-503-0372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO921637120101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health