Provider Demographics
NPI:1114301504
Name:SALDUA, EDMINA
Entity Type:Individual
Prefix:
First Name:EDMINA
Middle Name:
Last Name:SALDUA
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 1:1600 E DESERT INN RD STE 104
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-2505
Mailing Address - Country:US
Mailing Address - Phone:702-490-9009
Mailing Address - Fax:
Practice Address - Street 1:1600 E DESERT INN RD STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-2505
Practice Address - Country:US
Practice Address - Phone:702-490-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor