Provider Demographics
NPI:1508239906
Name:SALZER, DEANNE D (SLP, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:DEANNE
Middle Name:D
Last Name:SALZER
Suffix:
Gender:F
Credentials:SLP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:893 MIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:KULA
Mailing Address - State:HI
Mailing Address - Zip Code:96790-7514
Mailing Address - Country:US
Mailing Address - Phone:732-278-9565
Mailing Address - Fax:
Practice Address - Street 1:893 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:KULA
Practice Address - State:HI
Practice Address - Zip Code:96790-7514
Practice Address - Country:US
Practice Address - Phone:732-278-9565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-06
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI138103K00000X
HI1527235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist