Provider Demographics
NPI:1609524479
Name:SALAMANCA, ROXY ELAINE
Entity Type:Individual
Prefix:
First Name:ROXY
Middle Name:ELAINE
Last Name:SALAMANCA
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 1:31 POTTER ST
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-4924
Mailing Address - Country:US
Mailing Address - Phone:267-980-2749
Mailing Address - Fax:
Practice Address - Street 1:1200 OLD YORK RD STE 101
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-2034
Practice Address - Country:US
Practice Address - Phone:215-394-8625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC014108101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional