Provider Demographics
NPI:1982037099
Name:SALT, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SALT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-672 PU HOALOHA PL # 15
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-8801
Mailing Address - Country:US
Mailing Address - Phone:808-594-7689
Mailing Address - Fax:
Practice Address - Street 1:75-672 PU HOALOHA PL # 15
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-8801
Practice Address - Country:US
Practice Address - Phone:808-594-7689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst