Provider Demographics
NPI:1467732651
Name:SALGADO, DIOSCELINA (RD)
Entity Type:Individual
Prefix:
First Name:DIOSCELINA
Middle Name:
Last Name:SALGADO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-2019
Mailing Address - Country:US
Mailing Address - Phone:219-351-0028
Mailing Address - Fax:
Practice Address - Street 1:3115 RIDGE RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-2019
Practice Address - Country:US
Practice Address - Phone:219-351-0028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-19
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164005503133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL164005503OtherLICENSE NUMBER