Provider Demographics
NPI:1225187750
Name:SALAZAR, TERESA M
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:M
Last Name:SALAZAR
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 1:2425 LANCASTER DRIVE NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-1220
Mailing Address - Country:US
Mailing Address - Phone:503-566-2132
Mailing Address - Fax:503-566-2134
Practice Address - Street 1:2425 LANCASTER DR. NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1220
Practice Address - Country:US
Practice Address - Phone:503-566-2132
Practice Address - Fax:503-566-2134
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health