Provider Demographics
NPI:1164659231
Name:SALINAS, LOURDES V (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LOURDES
Middle Name:V
Last Name:SALINAS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 W 170TH ST
Mailing Address - Street 2:#6G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3201
Mailing Address - Country:US
Mailing Address - Phone:212-781-0420
Mailing Address - Fax:
Practice Address - Street 1:605 W 170TH ST
Practice Address - Street 2:#6G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3201
Practice Address - Country:US
Practice Address - Phone:212-781-0420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018887-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist