Provider Demographics
NPI:1629120183
Name:SALAZAR, MELISSA R
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:R
Last Name:SALAZAR
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 1:8312 PEBBLE CREEK WAY UNIT 204
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80126-6013
Mailing Address - Country:US
Mailing Address - Phone:303-741-1441
Mailing Address - Fax:
Practice Address - Street 1:8199 SOUTHPARK LN STE 120
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5665
Practice Address - Country:US
Practice Address - Phone:303-730-7117
Practice Address - Fax:303-730-7119
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12029760OtherASHA