Provider Demographics
NPI:1104035245
Name:SALTZMAN, DIANA GORENA (MED, LMFT, LMHC)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:GORENA
Last Name:SALTZMAN
Suffix:
Gender:F
Credentials:MED, LMFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 KINGS ML
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1730
Mailing Address - Country:US
Mailing Address - Phone:210-698-9731
Mailing Address - Fax:866-830-9432
Practice Address - Street 1:4 KINGS ML
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1730
Practice Address - Country:US
Practice Address - Phone:210-698-9731
Practice Address - Fax:866-830-9432
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002854-1101YM0800X
NY000596-1106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist