Provider Demographics
NPI:1346903747
Name:SALDIVAR, MADISON PAIGE
Entity Type:Individual
Prefix:MS
First Name:MADISON
Middle Name:PAIGE
Last Name:SALDIVAR
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MADDY
Other - Middle Name:PAIGE
Other - Last Name:SALDIVAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6510 S WESTERN AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-1712
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6510 S WESTERN AVE STE 400
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-1712
Practice Address - Country:US
Practice Address - Phone:405-634-1497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator