Provider Demographics
NPI:1891436358
Name:SALAS LIRA, ZAIRA Y
Entity Type:Individual
Prefix:
First Name:ZAIRA
Middle Name:Y
Last Name:SALAS LIRA
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 1:14321 SADDLEBRED WAY
Mailing Address - Street 2:
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-5882
Mailing Address - Country:US
Mailing Address - Phone:817-228-6741
Mailing Address - Fax:
Practice Address - Street 1:12512 WILLOW SPRINGS RD STE 100
Practice Address - Street 2:
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-3640
Practice Address - Country:US
Practice Address - Phone:817-812-2880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83923101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional