Provider Demographics
NPI:1730656976
Name:SALINAS, NATLIE MARINA
Entity Type:Individual
Prefix:
First Name:NATLIE
Middle Name:MARINA
Last Name:SALINAS
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 1:531 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:NV
Mailing Address - Zip Code:89301-1717
Mailing Address - Country:US
Mailing Address - Phone:385-230-8979
Mailing Address - Fax:
Practice Address - Street 1:531 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:NV
Practice Address - Zip Code:89301-1717
Practice Address - Country:US
Practice Address - Phone:385-230-8979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician