Provider Demographics
NPI:1578868790
Name:SALVADOR, SAMANTHA KANE (MA, LPA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:KANE
Last Name:SALVADOR
Suffix:
Gender:F
Credentials:MA, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9835 NORTHCROSS CENTER CT
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-7346
Mailing Address - Country:US
Mailing Address - Phone:704-896-8688
Mailing Address - Fax:
Practice Address - Street 1:9835 NORTHCROSS CENTER CT
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-7346
Practice Address - Country:US
Practice Address - Phone:704-896-8688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4049103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist