Provider Demographics
NPI:1295177558
Name:SALAZAR, DOLORES ANGELA (LMSW)
Entity type:Individual
Prefix:
First Name:DOLORES
Middle Name:ANGELA
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 969
Mailing Address - Street 2:
Mailing Address - City:OHKAY OWINGEH
Mailing Address - State:NM
Mailing Address - Zip Code:87566-0969
Mailing Address - Country:US
Mailing Address - Phone:505-852-1377
Mailing Address - Fax:505-852-1378
Practice Address - Street 1:1102A PASEO DE ONATE
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532
Practice Address - Country:US
Practice Address - Phone:505-852-1377
Practice Address - Fax:505-852-1378
Is Sole Proprietor?:No
Enumeration Date:2013-07-26
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-07613104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker