Provider Demographics
NPI:1114284833
Name:SALKIN, BRETT
Entity Type:Individual
Prefix:MR
First Name:BRETT
Middle Name:
Last Name:SALKIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29000 EMERY ROAD
Mailing Address - Street 2:
Mailing Address - City:ORANGE VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44022-1616
Mailing Address - Country:US
Mailing Address - Phone:216-591-0700
Mailing Address - Fax:216-591-0330
Practice Address - Street 1:29000 EMERY RD
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44022-1616
Practice Address - Country:US
Practice Address - Phone:216-591-0700
Practice Address - Fax:216-591-0330
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC . 0003727101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional