Provider Demographics
NPI:1639475221
Name:SALAZAR, SOILA REYNA (LMSW)
Entity Type:Individual
Prefix:
First Name:SOILA
Middle Name:REYNA
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 N RAUL LONGORIA RD
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-3600
Mailing Address - Country:US
Mailing Address - Phone:956-783-7368
Mailing Address - Fax:956-783-7860
Practice Address - Street 1:1103 N RAUL LONGORIA RD
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-3600
Practice Address - Country:US
Practice Address - Phone:956-783-7368
Practice Address - Fax:956-783-7860
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36641104100000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker