Provider Demographics
NPI:1699006908
Name:SALO, LEORA (MOT, OTR, LMT)
Entity Type:Individual
Prefix:
First Name:LEORA
Middle Name:
Last Name:SALO
Suffix:
Gender:F
Credentials:MOT, OTR, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 541221
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77254-1221
Mailing Address - Country:US
Mailing Address - Phone:713-557-5589
Mailing Address - Fax:866-557-7470
Practice Address - Street 1:9575 KATY FWY STE 290
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1406
Practice Address - Country:US
Practice Address - Phone:713-557-5589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-26
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105856225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist