Provider Demographics
NPI:1083326474
Name:SALOMON, MYRIANNE (MSED)
Entity Type:Individual
Prefix:MS
First Name:MYRIANNE
Middle Name:
Last Name:SALOMON
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 NEW YORK AVE APT 6H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-6163
Mailing Address - Country:US
Mailing Address - Phone:347-845-0098
Mailing Address - Fax:
Practice Address - Street 1:1304 NEW YORK AVE APT 6H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-6163
Practice Address - Country:US
Practice Address - Phone:347-845-0098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst