Provider Demographics
NPI:1952042160
Name:SALOMON, REESA DAWN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:REESA
Middle Name:DAWN
Last Name:SALOMON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 BERKSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1428
Mailing Address - Country:US
Mailing Address - Phone:973-996-8089
Mailing Address - Fax:
Practice Address - Street 1:18 BERKSHIRE RD
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-1428
Practice Address - Country:US
Practice Address - Phone:973-996-8089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00494800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist