Provider Demographics
NPI:1689964496
Name:SALETAN, JORDANA (LMSW)
Entity Type:Individual
Prefix:
First Name:JORDANA
Middle Name:
Last Name:SALETAN
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 1:3170 E FORT LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-1615
Mailing Address - Country:US
Mailing Address - Phone:520-795-4977
Mailing Address - Fax:520-795-4981
Practice Address - Street 1:3170 E FORT LOWELL RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-1615
Practice Address - Country:US
Practice Address - Phone:520-795-4977
Practice Address - Fax:520-795-4981
Is Sole Proprietor?:No
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-129761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical