Provider Demographics
NPI:1093958811
Name:SALAFIA, ANGELA
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:SALAFIA
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 1:1909 TYLER ST
Mailing Address - Street 2:SUITE 504
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-4527
Mailing Address - Country:US
Mailing Address - Phone:954-929-7515
Mailing Address - Fax:954-929-7510
Practice Address - Street 1:1909 TYLER ST
Practice Address - Street 2:SUITE 504
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-4527
Practice Address - Country:US
Practice Address - Phone:954-929-7515
Practice Address - Fax:954-929-7510
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2376106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist