Provider Demographics
NPI:1629495635
Name:SALAS, JULIA SOPHIE (MS)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:SOPHIE
Last Name:SALAS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11645 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3155
Mailing Address - Country:US
Mailing Address - Phone:305-538-8835
Mailing Address - Fax:305-938-4049
Practice Address - Street 1:11645 BISCAYNE BLVD
Practice Address - Street 2:SUITE 309
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-3155
Practice Address - Country:US
Practice Address - Phone:305-538-8835
Practice Address - Fax:305-938-4049
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2016-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13110101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health