Provider Demographics
NPI:1750028072
Name:SALAZAR, KATHY EDDY (SWI)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:EDDY
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:SWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 OCEAN PKWY APT 10F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-4623
Mailing Address - Country:US
Mailing Address - Phone:347-585-1120
Mailing Address - Fax:
Practice Address - Street 1:370 OCEAN PKWY APT 10F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4623
Practice Address - Country:US
Practice Address - Phone:347-585-1120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty