Provider Demographics
NPI:1770185779
Name:SALAZAR CASTANEDA, MABEL ESTHER
Entity Type:Individual
Prefix:
First Name:MABEL
Middle Name:ESTHER
Last Name:SALAZAR CASTANEDA
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 1:560 E 42ND ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-2350
Mailing Address - Country:US
Mailing Address - Phone:786-436-8147
Mailing Address - Fax:
Practice Address - Street 1:560 E 42ND ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-2350
Practice Address - Country:US
Practice Address - Phone:786-436-8147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician