Provider Demographics
NPI:1417600255
Name:SALCEDO, OLGA DEL C
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:DEL C
Last Name:SALCEDO
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 1:141 CALLE AUSTRAL
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-1737
Mailing Address - Country:US
Mailing Address - Phone:787-791-7957
Mailing Address - Fax:
Practice Address - Street 1:141 CALLE AUSTRAL
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-1737
Practice Address - Country:US
Practice Address - Phone:787-983-7246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7265103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical