Provider Demographics
NPI:1255507687
Name:SALVAT, MYONA (OT)
Entity Type:Individual
Prefix:
First Name:MYONA
Middle Name:
Last Name:SALVAT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MT
Mailing Address - Zip Code:59044-2023
Mailing Address - Country:US
Mailing Address - Phone:406-268-8251
Mailing Address - Fax:406-628-8253
Practice Address - Street 1:820 3RD AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MT
Practice Address - Zip Code:59044-2023
Practice Address - Country:US
Practice Address - Phone:406-268-8251
Practice Address - Fax:406-628-8253
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT893225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist